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Hmong Culture Health
Hmong Health Culture
The Hmong people are a group of Asian-Americans who have been living in the United States since an immigration program was started in 1975. Because of their strong animistic faith and beliefs in the supernatural, they have been slow to adapt to the healthcare practices of the United States. The Hmong continue to rely on alternative medicine and faith healers to cure illnesses.
Health Beliefs and Practices among the Hmong
The health practices and beliefs of the Hmong people are traditional for the most part. The Hmong are a spiritual people and this philosophy permeates their concepts of health and illness (Cha, 2010). Like all other matters of an individual's existence, the health of a person is also linked to the community. The clan elder is consulted in the case of a serious illness. The help of an herbal therapist massage therapist or acupuncture…
Cha, D. (2003). Hmong American Concepts of Health, Healing and Conventional Medicine. Routledge.
Cha, Y.P. (2010). An Introduction to Hmong Culture. McFarland.
Hamilton-Merritt, J. (1993). Tragic Mountains: The Hmong, the Americans and the Secret Wars for Laos, 1942-1992. Indiana University Press.
Her, V.K. (2012). Hmong and American: From Refugees to Citizens. Minnesota Historical Society Press.
Lia Lee could not be seen alone, as the doctors saw her. Their obligation was not only to her, but to her whole family.
Lia Lee's brother aptly writes: I do recall everything from the door slamming incident to the day the doctors told my family that it was okay for her to come but she will not live pass 7 days. I will never forget that week or those many years of pain my family or the doctors had to go through….We must understand that different cultures have different ways of curing a person and doctors have their policy they must follow. To avoid another incident like this, we must work together as a whole and not blame each other for not cooperating with one another
5. In many cases, patients cannot speak for themselves: It is not only Lia Lee. Patients can be old and frail, have dementia,…
hen the Hmong refugees encounter the peculiarities of the estern medical system, their entire worldview is called into question. Yet it is mainly the Americans who struggle. The Hmong view of health, healing, and wellness differ so sharply from that of the Americans that it is we who must examine our beliefs, not the Hmong.
History has not been kind to the Hmong. Yet in some ways, this cruelty has helped strengthen the culture. After all, the Hmong are known well among the tribes of Southeastern Asia. Part of this knowledge is due to the American use of Hmong during the Vietnam ar. As Hamilton-Merritt points out, though, the Americans used the Hmong as pawns and the Hmong paid dearly. hen the war ended for the Americans, it did not for the Hmong. Many were killed, and the society lost a significant portion of its elderly and female population. The…
Fadiman, Anne. The Spirit Catches You and You Fall Down. Farrar, Straus and Giroux, 1998.
Hamilton-Merritt, Jane. Tragic Mountains: The Hmong, the Americans, and the Secret Wars for Laos, 1942-1992. Bloomington, in: Indiana University Press, 1999.
arrival of Hmong to the United States and delves briefly on the earlier conditions of the Hmong in Laos and Southeast Asia, their region of origin.
The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures, by Anne Friedan is a book about the encounter between a Hmong family and the American medical community. It also goes into great detail about how the Hmong became allies to the Americans in the war in Vietnam. Hmong is a race of people that originates in China. The Hmong are agrarian, with animism (belief in individual spirits inhabiting natural objects) being their source of religious influence. In the early 1960's, the Hmong people were recruited by the CIA, to help the American Air Force in protecting their radar sites during the Vietnam War and were also entrusted with duties to fight off the…
Fadiman, A. (1997). The Spirit Catches You and You Fall Down. Farrar, Straus and Giroux.
e know that we do not know everything in the est. However, many aspects of the Hmong are also just coming out of the Middle Ages and there is only so much that can be tolerated and there must be a demand for a middle ground in the way that western medicine and culture deals with medical issues when the science and the treatment regimen is clear. For instance, Sudden Unexpected Death Syndrome needs to be studied (ibid 188n).
As stated in the book, "Although the Hmong believe that illness can be caused by a variety of sources - [...] by far the most common cause of illness is soul loss" (ibid 10). To bring these souls back into the body and to bring bodily health, soul calling ceremonies are seen to be important to the Hmong. There is no reason that such cultural flourishes can be tolerated and incorporated…
Fadiman, . The Spirit Catches You and You Fall Down. New York: Ferrar, Straus Giroux,
Spirit Catches You and You Fall Down by Anne Fadiman is a groundbreaking book about cross-cultural communication in health care. The book is about Lia Lee, who was the first in her Hmong family to be born in the United States. Her parents spoke no English. When Lia Lee was three months old, she had her first seizure. Due to misdiagnosis, a string of unfortunate events prevented Lia Lee from receiving the best possible care. Moreover, she was wrested from her family of origin and placed in foster care. The disruption to her life, the misdiagnosis, and the lack of communication between the health care team and her family led to her eventual death after decades in a persistent vegetative state. The Spirit Catches You And You Fall Down has become critical reading material for all health care workers seeking to provide the best quality of care in a multicultural…
Fadiman, A. (2012). The Spirit Catches You And You Fall Down. New York: Farrar, Straus, and Giroux.
Both healers could learn how to incorporate techniques that may be different from their respective cultures into how they treat medical conditions.
Ultimately Lia was put into foster care because the doctor believed that the parents were not caring for her properly. Lia's foster parents were Dee and to Korda. They had children of their own and wanted to care for Lia. Lia needed a great deal of care and affection and her foster mother gave her this affection even to the point of breast feeding Lia. I was not surprised at the level of affection; I was somewhat surprised that the foster mother breast fed Lia right along with her biological child. The foster parents did not belittle the Lees. Te foster parents tried to understand the Lee's perspective on medical care but they also understood the perspective of the American doctors and the fact that Lia needed to…
Fadiman a. (1998) the spirit catches you and you fall down: a Hmong child, her American doctors, and the collision of two cultures. Macmillan
The family would certainly have been more comfortable if the hospital made more of an effort to understand their culture and beliefs. The Lees were treated as if they were indignant and unresponsive to the needs of their child which was not the case at all. The hospital could have enlisted the help of affluent Hmong natives who have become more accustomed to American traditions. This person could have helped both parties, the Lees to understand medical necessities and the hospital staff to understand the importance of cultural traditions. Both parties could have used a trusted intermediary, Fadiman (1997) refers to this as a "cultural broker" (p. 265).
Another factor that would have made this experience easier for the Lees would have been if the medical professionals had an understanding of some of the important religious rituals and beliefs of their culture. Of particular importance to the Hmong is the…
Fadiman, a. (1997). The spirit catches you and you fall down. New York: Farrar,
Straus, and Giroux.
Medical training is all about treating patients who understand, there is little training for the patients who are not "normal," and so the medical community is ill prepared to deal with other cultures. The American doctors were saddened by Lia's condition, which deteriorated to a vegetative state after a two-hour long seizure, but they never took the time to understand how to really communicate with the Hmong. Even the social workers did not really know how to communicate with them. Much of the clash of cultures was due to lack of a common language, but even more was due to arrogance and sheer ignorance. The social workers and doctors could not conceive of people who did not read, did not know how to tell time, and could not understand even basic commands, even if they were translated effectively. The Hmong were from a poor, agricultural culture, and things Americans take…
Fadiman, Anne. The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. New York: The Noonday Press, 1997.
Spirit Catches You and You Fall Down
I believe Anne Fadiman was trying to prove that it is possible to work through tough cultural barriers by showing the mistakes of Lia Lee's doctors. By showing these examples, and also giving examples of how culture can work together, Fadiman is trying to prove that the American medical system needs to have other socially accepted avenues of therapy to work alongside of conventional medicine. The health issues faced by the Hmong Lee family, both from patient's point-of-view and the family's point-of-view are affected by their adaptation to the United States and their feelings toward health care and health care providers. It is hard to know what Lia Lee thought of her epilepsy since the audience never hears her voice an opinion on the matter. It is crystal clear, however, what the Lee family thought the health issue was: quag dab peg, roughly…
Fadiman, A. (1997). The spirit catches you and you fall down: A hmong child, her american doctors, and the collision of two cultures.. New York, NY: Farrar, Staus and Giroux.
e. according to American norms and conventions. Part of this, incidentally, was due too to the fault of government itself that failed to provide them with the land, which the Hmong could have fertilized.
I realized that even thoguh America has gone a long way in attempting to appreciate other cultures and in refraining from foisting their own way of life on cultures other than they; they still do so to a certain extent.
I also wonder why people found it so hard to understand that others coming from lives so different than they would need time to acclimate and learn their 'language'.
Most of all I was impressed with the steadfastness, courage, and resilience of the Lees to resolutely cling to her traditions and way of life despite recrimination and hardship.
There are some things that are better in the Hmong culture than in the Western culture, such as…
Fadiman, A. The spirit catches you and you fall down. Farrar & co., 1997
Within this clash of cultures, the Lee family did not know how to cope with the medical system in place to help Lia and her epilepsy. When they refused to give her the medications, Lia was removed from the home and placed in foster care. When the foster care parents gave her the prescribed medication, her condition worsened in several important ways. The foster parents believe that Lia's parents realized that, and that this is why they did not give her the medication, but did not have the cultural and language skills to communicate this to the medical staff.
Fadiman points out through example after example that the medical staff looked at Lia only as her illness, not as an individual, and certainly not as an individual part of a strongly developed culture that was markedly different than the hospital culture within which the doctors worked. Through a translator, a…
growing to adulthood in the United States, an young child and then an adolescence is encouraged to increasingly become more independent. By the age of three, many children are already going to nursery schools and then pre-kindergarten. In a restaurant or store, parents tell their kids to ask for help rather than doing it for them. By the time someone is an adolescent, he/she is expected to begin taking responsibility for school work and activities such as practicing musical instruments or sports. In high school, students are expected to begin planning their future in terms of education and careers. When college is over, they should ready to move into the mainstream and start their future lives and employees and parents of their own children.
Thus, most Americans usually believe that it is important to be autonomous and self-reliant. They know they are members of a community, city and the United…
TANF Time Limits
The Temporary Assistance for Needy Families, or TANF for short, is one of the more controversial and maligned or one of the most lauded and touted social safety net programs in the United States. Whether it is praised or denigrated depends a lot on who is doing the talking and what their motivations are. TANF has turned in a political football on a scale that dovetails quite nicely with the words of awls (1985) when it was noted in an essay of that author that there are sometimes periods (some of them quite long in duration) that are bereft and full of political divisiveness and vitriol (awls, 1985).
History of TANF & its Predecessor
A bulk of the TANF program is to provide cash-based payments to needy families who are living in destitution or are otherwise in stark financial peril and how those funds are allocated, to…
Alcoff, Linda. "The Problem of Speaking For Others." Cultural Critique 20.1 (1992): 5-
Burns, M. (2010, October 28). Welfare Reform Failing Poor Single Moms, Books Claim. Pacific Standard - Politics, Health, Economy, Environment, Culture, Education. Retrieved April 16, 2013, from http://www.psmag.com/politics/welfare-reform-failing-poor-single-mothers-24778/
CDSS. (2013, April 16). Child Welfare Services Stakeholder Group Questions and Answers. CA CDSS. Retrieved April 16, 2013, from http://www.cdss.ca.gov/cdssweb/PG51.htm
Culture and Counseling
In her book The Spirit Catches You and You Fall Down, author Anne Fadiman recounts the life and death of a little Hmong girl living in Merced, California. Lia Lee had what Western doctors call epilepsy, and which the Hmong have a far more lyrical explanation that lends itself to the title of Fadiman's book. The most common neurological disease, epilepsy can be frightening and potentially debilitating. However, in cultures around the world and throughout time, from the Hmong to the ancient Greeks, epilepsy opens pathways to creativity and an increased understanding of the universe. Thus, as Fadiman points out, many epileptics become shamans. When Lia Lee first started having epileptic seizures, her mom Foua, speaking not a word of English, rushed her to the Merced Community Medical Center. There, doctors tended to the eight-month-old child as best they could under the circumstances. Because all she was…
To a culture that didn't use calendars, giving a certain medicine at a certain hour of the day was incomprehensible. Neil and Peggy didn't consider that a somewhat less effective, but easier-to-follow drug regimen may have been better given the state of affairs. Instead, the estern idea of doing as much as medically possible for as long as medically possible prevailed. hen Nao Kao and Foua failed to comply, Neil and Peggy viewed them as unable or unwilling to follow what was to them, directions that could save Lia's life. If Neil and Peggy had asked Nao Kao and Foua why they didn't comply, perhaps a productive dialog could have been created. hen the author asked Peggy and Neil about it, they said that they had had no idea that Nao Kao and Foua would even consider traditional medicine, because they looked so Americanized.
Despite Neil and Peggy's perceptions, Nao…
Management Sciences for Health. (2005). Techniques for Taking a History. Retrieved December 7, 2011, from Reducing Health Disparities in Asian-American and Pacific Islander Populations: http://erc.msh.org/aapi/tt10.html
Rabin, R.C. (2010, November 2). Respecting Muslim Patients' Needs. The New York Times .
Yurkiewicz, S. (2011, April 8). "What Do You Think Caused Your Disease?." Retrieved December 7, 2011, from This May Hurt A Bit: PLoSBlogs: http://blogs.plos.org/thismayhurtabit/2011/04/08/what-do-you-think-caused-your-disease/
The Usefulness of Anthropology in a Globalized Society
In his seminal text, The Naked Ape, Desmond Morris examines the biological basis for modern human behaviors in urban settings, and makes the point that some of the more baffling ways that people act today can be traced to evolutionary responses to the exigencies of the prehistoric environment. Since its publication in 1967, this anthropological analysis has been followed by a growing body of scholarship concerning evolution and ecological principles and their implications for modern society (Dunaif-Harris, 1987). Today, the concept of gender is undergoing increased scrutiny and notions such as pansexuality have emerged in response. The fundamental debate concerning nature versus nurture, though, still remains unresolved with respect to extent to which the environment influences modern gender roles, most especially those included in the lesbian, gay, bisexual, transsexual and queer (LGBTQ) communities. This paper provides a review of the relevant literature…
Defend or reject: Buchanan and Brock would rightly defend the decision of the court to remove Lia Lee from the custody of her parents and place her in a foster home
Deciding for others: competency
This essay involves defending or rejecting the statement that Buchanan and Brock (2008) would rightly defend the decision of the court to remove Lia Lee from the custody of her parents and place her in a foster home. Although the statement might seem clear, the term "rightly" introduces an ethical twist to the whole discussion and the need to have an ethical theory to qualify right and wrong within the decision.
Plan for the Essay
The essay first defines the incidents surrounding the circumstances of Lia Lee and the verdict of the court. The dispute of competency follows next and the essay analyzes the issues at hand incorporating the views of Buchanan and Brock (2008).…
Fadiman, A. (1998). The Spirit Catches You and You Fall Down. New York: Macmillan
Buchanan A.E., Brock DW. (2008). Deciding for others: Competency, in Steinbock, B., Arras, J., London, A.J. (eds.), Ethical Issues in Modern Medicine. McGraw-Hill.
Freeman, J.M. (2007). Ethical theory and medical ethics: a personal perspective. Teaching and Learning Ethics, 617-618.
Beauchamp, T.L. (2003). Ethical Theory and Bioethics, Contemporary issues in Bioethics, 6th ed., New York: Wadsworth.
Spirit Catches You and You Fall Down is a book by Anne Fadiman about cross-cultural communications, or lack thereof, in the American health care system. The book is about a child named Lia Lee. Lia Lee was the first in her family to be born in the United States. Her parents are Hmong, which is a hill tribe that was settled mainly in Laos and which helped the American government during the War in Vietnam. The Hmong were displaced and persecuted, and thus afforded refugee status. This book is about how the immigrants spoke no English, had different values toward health care, and were therefore excluded from receiving the quality of care needed. As a result, their daughter was taken away from them and eventually Lia Lee became a vegetable and recently died.
When Lia Lee was an infant, she had her first epileptic seizure. However, doctors misdiagnosed the disease…
Fadiman, A. (2012). The Spirit Catches You And You Fall Down. New York: Farrar, Straus, and Giroux.
old Chinese proverb that I believe encompasses my feelings for the nursing profession. With the healthcare industry in its current state of disruption, it has become very important to re-evaluate the relationship of patient care and patient satisfaction. "Sometimes patient satisfaction needs to be measured one patient at a time. This usually has nothing to do with the impersonality of the plan, the aloofness of the provider, or the quality of the specialists to whom one is referred. Rather, it involves the basic rationing philosophies of HMOs, particularly the for-profit variety." (Birenbaum, 107) We can't forget that the business objectives of HMO's aim to purchase services and materials at the lowest price possible and trying to lock in a price in advance. HMO's have therefore changed the philosophy of the healthcare industry. As nurses, we have to make the best of this atmosphere. This essay therefore serves as the final…
From the perspective of professionalism, I have learned that as a nurse, it is best to continue to function in the day-to-day with an open mind and to also be prepared to look for a viable solution through detailed research. For example, I have discovered that the Hmong philosophy may not have been all that far fetched. Shamanism is actually the foundation of many modern medical cures including various technologies, sciences and medicines. Shamanism has also been unofficially credited with having discovered the fact that the ability of people who have suffered a state of amnesia, epilepsy or other 'soul splitting' similar to Lia's are actually one way that the body allows for time to heal from brain trauma induced by accidents or other physical abuses. "There is a doorway within our minds that usually remains hidden and secret until the time of death. The Huichoil word for it is neirika. Neirika is a cosmic portway or interface between so-called ordinary and non-ordinary realities. It is a pathway and at the same time a barrier between worlds." (Halifax, 1991)
Lia's father may not have been right about the doors slamming as the stimulus, but he may have been on to something with the notion of a splitting of the soul. Long before modern psychology or medicine, Shamanism discovered that children used soul splitting events like epilepsy, amnesia, sleep and even comas to heal from events like mentally traumatic or emotional disturbances such as the loss of their parents or siblings. Just like modern medicine and psychology, shamanic journeys that realigned the human soul have been proven to have healed some forms of depression, helped in coma recoveries and more. When Lia was alive and well years after the western world had assumed she would not live more than a few months at best, the western world could have benefited by admitting that in this case at least, the Hmong way of life may have been superior. I believe that what I have learned from this class and from the story will advance me as a future nurse because I will apply the ideas of open mindedness with detailed research.
As the HMO payment philosophy
spirit catches you and you fall down.
Notions of epilepsy amongst the Hmong nation are diametrically different to those of the West.
The Hmong believe that epileptic individuals are particularly fancied by malevolent spirits (called 'dabs') that enter their bodies, make them sick, and allow them to communicate with the spirit realm in order to serve as mediums to help others in their present existence and to communicate with those who are dead.
This religious belief is called shamanistic animism, which asserts that malevolent spirits are constantly seeking human souls to inhabit, particularly those of vulnerable or unloved children (although Lia, in this case, was the favorite child) and that epilepsy is but one instance of the spirit's inhabiting the human body.
In Hmong culture, epilepsy is referred to as quag deb peg (I.e. "The spirit catches you and you fall down."). Perceived as an honorable condition, the epileptic individual…
Fadiman, A. The spirit catches you and you fall down. Farrar & co., 1997
2008). Developing cultural competency -- the ability to understand or even achieve the point-of-view of a different culture -- is an essential skill for doctors, and even more so as globalization continues to bring people of disparate backgrounds and belief into contact more and more every day. Proper training and exposure to the techniques of eliciting perspective-demonstrating comments has become increasingly standard practice in Western and non-Western medical schools, which can only lead to the better health and overall well-being of patients worldwide (Ho et al. 2008). Had these methods been employed in this scenario, the outcome for all concerned could have been very different.
When it comes to the parents' decisions and attitudes throughout the ordeal of their daughter Lia's illness, there are also some choices that could have been made better and more effective. The very perspective that created the term "cultural competency" is inherently Western, however, as…
Fadiman, A. (1998). The Spirit Catches You and You Fall Down. New York: Macmillan.
Ho, M.; Yao, G.; Lee, K.; Beach, M. & Green, A. (2008). "Cross-cultural medical education: Can patient-centered cultural competency training be effective in non-Western countries?" Medical Teacher 30(7), pp. 719-21.
Schulze, H. (2009). "From biographical research to cross-cultural competencies in counseling." Tiltai / Bridges 45(1), pp. 115-24.
Advocacy groups, whether private or government-sponsored, ease transition from home to America but being uprooted poses severe psychological and sociological problems that are not easy to fix.
The United States remains one of the only nations to openly welcome immigrants as a national policy; Canada is another. For centuries the United States has relied on immigrant labor to fuel industry and add nuance to the nation's cultural fabric. The United States is no longer viewed as a melting pot because of the increased pride among immigrants in their native cultures and languages. Balancing assimilation with preservation of culture is still the most difficult task for immigrants, many of whom hope for a more stable life in the new world while still retaining the values and lifestyles of their ancestors.
Refugees continue to hold a unique social, economic and political status in the United States. As Tumulty notes, the Hmong assimilated…
Branigin, William. "Immigrants Shunning Idea of Assimilation." The Myth of the Melting Pot. Washington Post. May 25, 1998. Retrieved Jun 14, 2008 at http://www.washingtonpost.com/wp-srv/national/longterm/meltingpot/melt0525a.htm
Clemetson, Lynette. "Bosnians in America: A Two-Sided Saga." The New York Times. April 29, 2007. Retrieved Jun 15, 2008 at http://www.nytimes.com/2007/04/29/us/29youth.html?pagewanted=1&_r=1&adxnnlx=1213585920-/U4w96yxQS4h7/bEHNl%20Ug
Federation for American Immigration Reform. "How Mass Immigration Impedes Assimilation." Retrieved Jun 15, 2008 at http://www.fairus.org/site/PageServer?pagename=iic_immigrationissuecenters641a
The Great Immigration Panic." The New York Times. June 3, 2008. Retrieved June 15, 2008 at http://www.nytimes.com/2008/06/03/opinion/03tue1.html
They cannot ignore the socioeconomic issues of adversity so often present and, where necessary, need to act as advocates, mediators and social brokers (Compton, Galaway, & Curnoyer, 2005).
The concern is that the issue of healthcare for culturally diverse individuals is so complex, there are no exact rights and wrongs. For example, in Fadiman's book, no person(s) can be said to be ultimately correct or incorrect in his/her behavior or actions; everyone did what he/she thought was right. In order to help others who have different cultural backgrounds and experiences, as the Hmong, it is essential to be 1) proactive. That is, to forecast the transforming demographics in the U.S. over the coming decades and put plans into place that will best serve these individuals and 2) collaborative. The best results occur when professionals from different backgrounds and expertise share best practices and learn from each other. What could have…
Compton, B., Galaway, B., & Curnoyer, B.R. (1994). Social work processes (7th ed.).
Pacific Grove, CA: Brooks/Cole.
Fadiman, Anne (1997) the Spirit Catches You, and You Fall Down. New York: Farrar, Straus and Giroux.
Gladwell, M. (2002). The tipping point: How little things can make a big difference. Boston: Little Brown
Furthermore, the policy seems to put a burden on the hospital to help provide those services, which seems to put an undue burden on the hospital. Writing policies that guaranteed access would be permitted, but did not in any way guarantee facilitation of that access would seem to be a better policy.
One of the least understood religious groups in the United States is the Church of Scientology. There is a strong belief that members of this religious group are adverse to modern medical care, a belief that I shared before researching their organization. However, from the information that I could find, Scientologists are not opposed to modern medicine. On the contrary, the Church of Scientology has an official policy of not being involved in either medical diagnosis or treatment of medical illnesses. They believe that underlying illness inhibits a person's spiritual journey, so that they encourage members to seek…
Church of Scientology. (2012). Do Scientologists use medical doctors? Retrieved March 6,
2012 from Scientology Newsroom website: http://www.scientologynews.org/faq/do-scientologists-use-medical-doctors.html
Hmong shamans help at Valley hospitals. (2009, November 10). Retrieved March 5, 2012 from Fresno Bee website: http://www.fresnobee.com/2009/10/10/1669868/hmong-shamans-help-at-valley-hospitals.html
Faidman, Anne. (1998) The Spirit Catches You and You Fall Down. New York: Farrar, Straus and Giroux.
The title of Anne Fadiman's book on the implications of multiculturalism in modern nursing sounds more like a religious testimony than a textual asset to the modern nursing profession. However, Faidman tells a tale of Biblical proportions, and the emotional nature of The Spirit Catches You and You Fall Down is epic in its intensity. Moreover, the title is indeed descriptive, for it encompasses in its scope not simply faith, but also functions as a description of the symptoms of epilepsy that affects the patient at the book's core. The title describes how the parents of the patient viewed the symptoms of their child, in direct contrast to the representations of the modern medical system in America, whom treated this young child of recent immigrants. (Faidman, 1998)
The main theme of Faidman's…
Faidman, Anne. (1998) The Spirit Catches You and You Fall Down. New York: Farrar, Straus and Giroux.
Hendricks, C., Byrd, L. et al. (2001). "Self-esteem matters: Racial and gender differences among rural southern adolescents." Journal of Black Nurses Association, 12(2).
Graff Asserts that literacy played a less significant role in the industrialization of American than was one thought. He argues that training people to read and write was not enough. Literacy alone was not enough to advance the industrialized nation (Cattau).
Douglas did not need to know how to read to perform his job in the shipyard. He only needed to know how to write four letters. He did not need to how to read and write proficiently. The workforce may have needed little bits of knowledge to perform their jobs, but this is different from being able to read and write fluently, which supports Graff's ideas on the importance of reading and writing to the industrial age. It relied more on the availability of a workforce, rather than the need for a literate workforce. The only ones that needed to learn to read and write were the managers and…
Akinnaso, F. Linguistic Unification and Language Rights. Applied Linguistics. 1994. Vol. 15. No. 2, pp. 139-168.
Brandt, Deborah. "Remembering Writing, Remembering Reading." CCC 45.4 (1994): 459-479.
Cattau, D. Harvey Graff argues for a clearer view of our sentimental notions. June 13, 1995. The Dallas Morning News. http://people.cohums.ohio-state.edu/graff40/outgrowingmyths.html Accessed May 29, 2008.
Douglas, Frederick. Learning to Read and Write. Online. http://www.gibbsmagazine.com/learning%20to%20read.htm . Accessed May 29, 2008.
Then, if the parents did not listen to the doctors, they assumed more of the responsibility of what happened. How could the doctors expect the medicine to be taken correctly when the parents did not read, did not know mathematical symbols and were given change after change. They were blindsided by their own diagnosis and the arrogance that everyone would follow their treatment exactly. Nor can the doctors be excused for not understanding the Hmong ways. Reading National Geographic (pg. 57) is not the way to learn about a culture! Dr. Murphy's comment that "[p]eople in the early years of their medical careers have invested an incredible amount of time and energy and pain in their training, and they have been taught that what they've learned in medical school is the only legitimate way to approach health problems" surely does not cover their actions, either. The story about Dr. Fife,…
The line of legitimacy, separating socially approvable use of force from violence, cannot be effectively drawn without an agreement on what constitutes the optimum amount of force necessary to maintain social order and to protect human rights against encroachment. A society subscribing to infinite morality which condemns all use of force as immoral is doomed no less than a society accepting the absolute pragmatism of tyrants. "
As Oleg Zinam proposes, these two extreme social attitudes to morality are equally unprofitable to the societies that adopt them. The attitude of absolute pragmatism can easily lead to the acceptance of political assassinations, as long as such acts may help the final political purpose. An example of absolute pragmatism can be the regime initiated by Hitler, who ordered the extermination of all Jews in an attempt to "purify" the human race by excluding anyone who did not fill in the Arian ideal.…
Ben-Yehuda, Nachman. 1997. Political Assassination Events as a Cross- Cultural form of Alternative Justice.
International Journal of Comparative Sociology, Vol.38: 25-30.
Feliks, Gross. 1974. The Revolutionary Party. Essays in the Sociology of Politics. Westport: Greenwood
Ironically, when Walt's last Will and Testament are read, he has left his house and estate to the Church; a final tribute to his wife's years of devotion, and even perhaps, we are given to believe, to Father Janovich's unwavering belief in the goodness of humans.
Walt is almost a quintessential example of someone who has become so embittered by the temporal world that he cannot see the beauty of life or the nature of spirituality. Walt likely went through life much as most of the Post World War II generation; life was planned, this is what you did; you fought for your country, came home, got a job, raised a family, retired, drank at the local pub, and let your wife handle the Church and all the emotional issues. Trouble is -- this paradigm often results in a great deal of burying emotions, of distancing from one's family, and…
Gran Torino (2010). Box Office Mojo. Cited in:
In an experiment, a Caucasian girl named Morgan was shown pictures of two girls - one white and one black.
hen asked who was smarter, Morgan pointed to the white girl. She was then shown a picture of a white and a black boy and was asked who threw garbage on the floor. She then pointed to the black boy (Stern-LaRosa and Bettman 2000).
Morgan is only three years old.
The experiment shows how early prejudice can affect people's perceptions, and the various negative ways in which they are manifested.
Morgan, however, is far from a lost cause. Experts agree that children often look to adults for guidance, and that there are many strategies to help children like Morgan work through their attitudes towards difference.
Definitions of prejudice
Studies of prejudice and discrimination usually center on a group of common ideas. Most experts begin with stereotypes, which are…
Cohen, Warren. 1999. "Sticks and stones." U.S. News and World Report. March 1, 1999, p. 61.
Doyle, Anne B. And Frances Aboud. 1995. "A Longitudinal Study of White Children's Racial Prejudice as a Social-Cognitive Development." Merrill-Palmer Quarterly, 4(2): 209-228.
Powlishta, Kimberly et al. 1994. "Gender, Ethnic, and Body Type Biases: The Generality of Prejudice in Childhood." Developmental Psychology, 30(4): 526-536.
Stern-Larosa, Caryl and Ellen Hofheimer Bettmann. 2000. Hate Hurts: How Children Learn and Unlearn Prejudice. New York: Scholastic.
Needless to underline the difficulty of the this challenge.
Another author who is concerned with why the prevention programmes fail in this specific cultural environment is Catherine Campbell. She believes that while external help is fundamental, so is mobilizing the local community is the direction of prevention. Peer education made in informal scenery is believed to be the first necessary step. Another step would imply reaching the target represented by children and teenagers. This means "promoting peer education in a formal school setting" as well. "Mobilizing stakeholders to prevent HIV" is the third measure which she takes into consideration. "In the past few years, some development practitioners and agencies have attempted to acknowledge the complex and contested nature of local communities through the growing popularity of the concept of the "multi-stakeholder community." The recognition that geographical areas are often home to a range of different "stakeholders" represents an important first…
Attwood, G. REFLECT- Learning circles in the Malealea Community Development project
Campbell, C. Letting them die: why HIV / AIDS intervention programmes fail. Google Books. Retrieved October 5, 2010 from http://books.google.it/books?id=xZME3SMJUwcC&printsec=frontcover&dq=catherine+campbell+letting+them+die&source=bl&ots=L2WZ6lJaV2&sig=Le2k1h7d68hGxxDTBo8HM_nisYs&hl=it&ei=iPqtTIvdGczEswbxxv29DQ&sa=X&oi=book_result&ct=result&resnum=1&ved=0CBUQ6AEwAA#v=onepage&q&f=false
Dunton, C. - Audio
Epstein, H. The invisible cure. Retrieved October 7, 2010 from http://www.youtube.com/watch?v=VSPk8K5zK3I
Meng and Meurs (2009) examine the effects of intermarriage, language, and economic advantage. They find that immigrants who have some skill in the dominant language of the country to which they immigrate tend to intermarry and earn more income (Meng and Meurs). Marrying outside of one's culture may influence language acquisition due to social and economic needs to advance within the adopted culture.
Moua and Lamborn (2010) note that ethnic socialization practices by parents of immigrant adolescents strengthen the ethnic heritage connection between adolescent, parent, and ethnic community. These include native language use, marriage ties, taking part in cultural events, sharing history, and preparing traditional foods (Moua and Lamborn). As noted previously, immigrant parents tend to congregate in ethnic communities, where they are essentially immersed in the ethnic culture. The native language is often the most utilized if not the exclusive language in the home. However, children are acculturated into…
Akresh, I. "Contexts of English Language Use among Immigrants to the United States." International Migration Review (2007): 930-955.
Bacallao, M and P. Smokowski. "The Costs of Getting Ahead: Mexican Family System Changes After Immigration." Family Relations (2006): 52-66.
Blatchley, L and M. Lau. "Culturally Competent Assessment of English Language Learners for Special Education Services." Communique: Newspaper of National Association of School Psychologists May 2010: 1-8.
Bleakley, H and A. Chin. "Age at Arrival, English Proficiency, and Social Assimilation Among U.S. Immigrants." American Economic Journal of Applied Economics (2010): http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2813069/pdf/nihms-132959.pdf .
" (Dafler, 2005) Dafler relates that for more than thirty years children who were 'half-caste' "were forcibly removed from their families, often grabbed straight from their mother's arms, and transported directly to government and church missions." (Dafler, 2005) This process was termed to be one of assimilation' or 'absorption' towards the end of breeding out of Aboriginal blood in the population. At the time all of this was occurring Dafler relates that: "Many white Australians were convinced that any such hardship was better than the alternative of growing up as a member of an 'inferior' race and culture." (2005) it is plainly stated in a government document thus:
The destiny of the natives of Aboriginal origin, but not of the full blood, lies in their ultimate absorption by the people of the Commonwealth, and [the commission] therefore recommends that all efforts be directed towards this end." (eresford and Omaji, Our…
Dafler, Jeffrey (2005) Social Darwinism and the Language of Racial Oppression: Australia's Stolen Generations ETC.: A Review of General Semantics, Vol. 62, 2005.
Erich Fromm Foreword to a.S. Neill SummerHill (New York, 1960).
Hawkins, Social Darwinism; Shibutani, Tamotsu and Kwan, Kian M. Ethnic Stratification: A Comparative Approach. New York: The Macmillan Company (1965).
Jacques Ellul, the Technological Society (New York, 1967), 436.
In the world of medicine today, there is still much about the inner workings of the human brain that are relatively unknown. Yet advancements in brain scanning and other techniques are giving researchers greater insight on how epilepsy works and why the brain responds as it does to the seizures. Obviously, with advances in genetic testing and the existence of the Human Genome Project, epilepsy could one day be cured and thus help millions of sufferers to live a "normal" and non-disabling lifestyle.
Chadwick, David. Living with Epilepsy. London: Optima Publishing, 1987. (An excellent book which explains in-depth how a person can cope and live with epilepsy. It also provides information on support groups for those afflicted with the disease).
Preston, Robb. Epilepsy: Causes and Treatments. Miami, FL: Symposia Specialists, Inc., 1980. (Another excellent book that discusses all the major aspects of epilepsy. It also provides much information…
Chadwick, David. Living with Epilepsy. London: Optima Publishing, 1987. (An excellent book which explains in-depth how a person can cope and live with epilepsy. It also provides information on support groups for those afflicted with the disease).
Preston, Robb. Epilepsy: Causes and Treatments. Miami, FL: Symposia Specialists, Inc., 1980. (Another excellent book that discusses all the major aspects of epilepsy. It also provides much information on what a person should do when someone is experiencing an epileptic seizure).
The Spirit Catches You and You Fall Down." Book Review. Internet. 2003. Accessed September 19, 2005. http://www.spiritcatchesyou.com/bookdescription.htm .(A very thorough review of Anne Fadiman's book which describes Lia Lee's battle with epilepsy, both medically and culturally).
Successful sustainable development also requires an evaluation of major trends and problems in the tourism industry rather than focusing on minor new developments that may have localized impact only (Butler, 1998).
Taken together, the foregoing indicates that irrespective of the precise definition that is used, sustainable tourism development is based on three main principles, economic, environment and social which are described below:
1. Economic: This principle refers to something that affects to the majority number of people and enhance the economic situation which is related to sustainable management of economic in tourism sector. This can regarded as opportunities to educate and train employees, support local suppliers, trade, producers and so on (Chapman, 2007). This principle is consistent with the observation by King (2008) that, "tourism in Thailand, as with tourism in the Asian region more generally, is a highly diversified, complex, and changing phenomenon, the impact and consequences of which…
'Bung Kan Is Thailand's 77th Province.' 2011, March 23. Pattaya Daily News. [online]
available: http://www.pattayadailynews.com/en/2011/03/23/bung-kan-is-thailand%E2%80%99s-77th-province/ .
Burton, S., & Steane, P. 2004. Surviving Your Thesis. New York: Routledge.
Cater, E. 1993. 'Ecotourism in the Third World: Problems for Sustainable Tourism
Healthy Again Health Promotion Program
Parts B & C -- Competency Statements and elevant Objectives
Nurse professionals will endeavor to work as a team in collaborative relationships whenever possible.
Nurses understand and engage in effective communication
Work with team and colleagues to ensure a safe and effective medical environment
Authenticate relationships between colleagues, patients, and stakeholders through mutual respect and honesty
Engender and actively pursue a cycle of learning and improving self and through professional means, others
Create a culture of respect, advocacy, caring, and trust (American Nurses Association, 2013).
Nurses will adhere to the ANA Nursing Code of Ethics in all work situations, and will communicate to supervisor in the event of additional resources or interpretations (American Nurses Association, 2013).
a. Understand and adhere to basic nursing ethical guidelines through advocacy, communication and deliberate leadership by example
b. Deliberately and regularly work to provide patient autonomy, beneficence, fidelity and…
Code of Ethics for Nurses. (2012). Retrieved from: http://www.nursingworld.org/
American Nurses Association. (2013). Professional Standards. Retrieved from:
diverse population nurses must attend to, the concept of 'transcultural' nursing is important to understand. Instead of viewing health as a universal concept, transcultural nursing attempts to understand the conceptual building blocks of the nursing profession as cultural products that are socially-constructed. It strives to understand the similarities and differences between different health attitudes and practices (Leininger 1991). First developed by Madeline Leininger, transcultural nursing is founded upon the idea that the "health care providers need to be flexible in the design of programs, policies, and services to meet the needs and concerns of the culturally diverse population, groups that are likely to be encountered" (Transcultural nursing, 2012, Current Nursing).
Nurses must be culturally astute and adapt their practices to patient's cultural needs as well as to physical needs. This concept has been somewhat controversial within the nursing profession given that Western medicine's emphasis on preserving life and optimizing treatment…
Adult obesity facts. (2013).CDC. Retrieved: http://www.cdc.gov/obesity/data/adult.html
Dorothea Orem's self-care deficit theory. (2012). Nursing Theories. Retrieved:
Milligan, F. (2008) Child obesity 2: recommended strategies and interventions. Nursing Times;
Multicultural Patient Care
The Market Orientation of the Family Birthing Center is no doubt, diverse. It is also an excellent avenue for health care reforms as the community hospital is forced to cater to the needs of people that speak 40 different languages, to do it well, and to serve as an example for other hospitals that multicultural patient care is possible and could be done in the best possible way (Noonan & Savolaine).
As the demographics of the United States continue to change to include more foreign nationals, health care professionals need to become increasingly aware of multicultural issues. Developing a greater cultural awareness of a particular client population can aid health care providers in improved care giving. ith the steady increase of people from other countries coming to the United States, health care professionals have been asked to assess and respond to the needs of a more diverse…
Noonan, M.D., and Savolaine, R. (2001. Winter). A neighborhood of nations. Marketing Health Services.
Peterson, R. (1996. April 1). A patient care team approach to multicultural patient care issues. Journal of Nursing Care Quality.
Post Staff Writer. (2002. May 12). International Deliveries; Maternity Wards Adapt to Special Needs of Region's Rush of Immigrants. The Washington Post.
gifted and talented education for minority students. The writer explores the screening process for gifted and talented programs and the various problems that screening process causes when it comes to locating and educating minority students. The writer also explores the societal mindsets and the urban areas that play a part in the overlooking of minority gifted students. The bulk of the exploration is done with a literature review on previous studies, research and decisions regarding the screening and education of minority gifted students. There were ten sources used to complete this paper.
Each day across the nation millions of students sit in classrooms and are educated. The classrooms contain a large number of students and the lessons are designed and geared to reach the largest students in each setting. This means that for the most part the lessons are aimed at the average intellect and average abilities student. Within the…
MacMillan, D.L., & Reschly, D.J. (1998). Overrepresentation of minority students: The case for greater specificity or reconsideration of the variables examined. The Journal of Special Education, 32, 15-24.
Singh, N. (1996). Cultural diversity in the 21st century: Beyond e pluribus unum. Journal of Child and Family Studies, 5, 121-136
U.S. Department of Education. (1996). Application for new grants: Program for children and youth with serious emotional disturbance. CFDA No. 84.237G. Washington, DC:Author.
U.S. Department of Education. (1997). To assure a free appropriate public education to all children with disabilities: Nineteenth annual report to Congress on the implementation of the Individuals with Disabilities Education Act. Washington, DC: Author.
American immigration policy and population patterns have changed in response to labor demands and economic forces, as well as shifts in American identity and social norms. Global forces have also shaped immigration patterns over the past hundred years. Anti-immigration sentiments have also strongly influenced immigration policies, with the most notable examples from a century ago being the Chinese Exclusion Act of 1882 and the Nativist movement of the 1920s (Young 1). Similar Nativist sentiments bubbled to the surface during the Trump administration, clouding constructive discourse on the role and status of immigrants in the United States, and the fundamental functions of immigration policy.
Although the United States was always a settler nation, immigration trends changed in the early 20th century. Immigrants from Southern Europe and Eastern Europe started to pour in before the First World War, pushed by economic uncertainties and outright poverty and pulled by the promise of readymade…
Spirit Catches You and You Fall
There were a number of different delivery systems models in place and which attempted to effect positive care for Lia Lee and her family in Anne Fadiman's The Spirit Catches You and You Fall Down. One can successfully argue that more than one model was used throughout the duration of the book for the simple fact that there were a number of barriers preventing success from any of the models due to the simple fact that Lia's family were Laos immigrants with little cultural understanding of the United States. However, it is fairly evident that the model that was initially used and used more than any others in this work of literature was the medical model. The medical model is commonly used within westernized society and is the oldest of the three traditional models (which includes the public health and the human services model,…
Cross-Cultural ssues for African-Americans
The chapter on African-Americans primarily discusses three main cross-cultural issues. The first and most obvious one is the physical difference between white and black Americans, which is more pronounced than between Caucasians and any other minority group. This leads to an immediate, visual acknowledgment of difference and the predominance of severe racism that keeps people from being promoted, thinks they are less worthy, and makes them work harder for the same recognition. The second main cross-cultural issue seems to be one of group guilt. The chapter seems to suggest that blacks see individual whites as individually responsible for their actions, but whites seem to see blacks as responsible for the actions of all other blacks, seeing them not as individuals but as a profiled group. n addition, if some blacks are incompetent or criminal, they are all seen that way. The third and most cultural of…
If the office doesn't accept people who speak their minds, maybe we should keep our mouths shut more? If it's company policy not to get all up in someone's face and talk them down, then maybe we should respect that. It seems fair to have rules about how people should behave, even if it goes against the grain for blacks who are from a far more open culture. If a lot of tact is necessary for the job, though, we need to have it. On the other hand, if only black people are supposed to be tactful and polite, that's a problem. Having to always be submissive is degrading. It always made me angry when a little white girl could talk back to the teacher and he'd listen to her, but when I talked back it was seen as giving lip or even being aggressive just because of my cultural voice. I was interested to see that one person they quoted said that he hated being asked why he didn't act black (and thus they insinuated that he could, if he wanted) because he just wasn't like that, and someone else said they hated having to not act black. I don't think there's an across the board answer for whether people want to be accepted as a stereotype, or not.
In the end, the chapter was a very positive thing, if only to get people thinking about racism. There's a lot of racism in the workplace, I'm sure, because I saw a lot of it at school. I guess my one critique to the author, but even more to blacks everywhere would be: we needed to decide how we want to be treated, and then address it openly. Do we want to be seen as our color and take pride in it, and "act black" or do we want to fit in? Do we want to be treated as a group, or as individuals? Do we want to act like everyone else, or like ourselves? If we're willing to behave differently than everyone else, are we willing to accept the consequences?
Blank, Renee & Slipp, Sandra. (1994). African-Americans. In Voices of Diversity: Real People Talk About Problems and Solutions in a Workplace Where Everyone Is Not Alike. New York: Amacon.
Culture's Impact On Healthcare
Culture: Midwestern, (White Female)
The following are the top 5 characteristics of my culture:
Conservative political values. May cause a closed mine and limit the imagination. Political lines are dogmatic and prevent free thinking.
Family orientated. This bias may cause the individual to be too loyal on one's family. It is very difficult to see our families for who they truly are.
Open minded: Too much open-mindedness may lead to foolish mistakes and jumping on any bandwagon that may come along.
Love of the outdoors and social activities. Too much of this behavior, may lead to not refining the indoor skills that are important in life.
Trusting to new experiences. Too many new experiences may lead to becoming ungrounded.
The Midwestern culture is very conservative and many within the culture base their decisions on popular notions and ideas. Health care to Midwestern culture…
Arterberry, K. (nd). Cultural Competence. Provided by customer.
Hearnden, M. (2008). Coping with differences in culture and communication in health care. Nursing Standard, 23, 11, 49-57.