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Classmate1:

  Summary  There were many historical events and cultural practices in the Hmong culture. First of all it was so hard to appropriately treat Lia’s epilepsy due to unfortunate circumstances. The family had their cultural beliefs and secondly there was a language barrier that stood in the way, that did not allow them to fully understand the diagnosis, and the severity if not treated. They believed that the seizures she was having made her special. They believed in traditional healing per their cultural beliefs, and this was was to call back her soul. They believed that traditional medicine would put limitations on the spiritual healing. They had no idea that this was a neurological disorder, she possible was born with this and had not realized or evolved as she got older. Epilepsy is not caused by someone hearing a noise at the door. They believed that this noise caused her spirt to leave. The child had to go through what she had to due to strong cultural beliefs. The differences between U.S. health and Hmong in California is; spiritual healing and traditions that the spirits affect human lives, their traditional ways are super important, they great respect for the elders, this is why the younger generation does not try to impose traditional medicine as in the U.S. The U.S. would have treated her as the primary care physicians suggested. Due to ongoing seizures untreated the brain was affected, and she became mentally retarded. The social workers reunited her with her family, but the damage was done. She also suffered trauma from being separated from her family, as the primary care physician thought this was best as it was a form of neglect on the families part. When the decision to administer the medication was finally made, her condition worsened and she had a grand mall seizure which is the worst, and then her body went into septic shock. She came home and lived for 26 years, they still traditionally had ceremonies to ease her suffering and believed that it worked. Very strong tradition, beliefs and cultural background. It speaks for itself, and they fought hard to maintain their culture. They stuck together and stood ground for what they believed in, they did not surrender or submit to traditional medicine and doctors ways. They thought that the body had minimal amount of blood, and that taking ones blood could be harmful and or fatal, surgeries to lead to disfiguration and that if an autopsy was to be preformed after death, that the persons soul would never become reborn again. They stood firm on their beliefs, and really did not care to hear what the consequences or outcomes may bring. 

Part II Teamwork (Response)

Some historical events that were noted in reading these chapters were the ceremonies for the calling back of her soul, sacrificing of the animals. In the Hmong history and cultural they believe that your soul remains in the gravesite for 13 days. They pray and sing during this time , they don’t believe in having surgery, they communicate with the spirits on a continuous basis. They believe in life after death, a shaman is the person who is called to communicate with the spirits. they believe that a Shaman can cure a sick person, they have some minimal shamans, and have others who can preform more strongly. 

List of Key Cultural Practices (Response)

Would be to maintain relationships with their relatives. They have ultimate respect for their relatives and family members. They remember their sufferings, they want to live life and be free! I would say most importantly to the Hmong culture would be; family, cultural and spiritual traditions and rituals to go on for generations. They will preserve these cultural practices, by starting at a young age and it will come naturally. 

Part III Individual Reflection:

My team identified several factors, the spirits, and the significance of cultural meaning and rituals. We all touched on how strong the beliefs were that the culture was so strong, that the family was in denial that she was truly ill. These differences and beliefs are very different from from the U.S. traditional ways, some of these ways could be harmful but when it comes to dealing with cultural beliefs, all we can do is inform them, we are not able to force anyone to do anything. The language barrier was another added extra big problem, In the US this can also be compared to natural health care, some people choose not to take medications, for certain beliefs, they tend to go with a natural supplement approach, or herbal treatments. This would also be known as integrative medicine. My opinion is its fine to have strong beliefs and cultural differences. and try so hard to stay with what you believe in and were raised to do. When it comes to a point where you or your family member is that sick and needs help, one may have to set those aside as a special circumstance, I am sure it will be very difficult. Our culture is very different her in America, we believe in medicine, and if we are sick we automatically get treated. We have different cultures her in America, and we do have some very strict religious, and cultural families that just don’t get the recommend treatment for themselves nor their children. 

References:

Swihart DL, Yarrarapu SNS, Martin RL. Cultural Religious Competence In Clinical Practice. [Updated 2021 Dec 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493216/

Institute of Medicine (US) Committee on Health Literacy; Nielsen-Bohlman L, Panzer AM, Kindig DA, editors. Health Literacy: A Prescription to End Confusion. Washington (DC): National Academies Press (US); 2004. 4, Culture and Society. Available from: https://www.ncbi.nlm.nih.gov/books/NBK216037/

Ahn, L. H., Kivlighan, D. M., Jr., & Hill, C. E. (2022). Helping skills courses: The effects of student diversity and numeric marginalization on counseling self-efficacy, counseling self-stigma, and mental health. Journal of Counseling Psychology, 69(1), 27–36. 
https://doi.org/10.1037/cou0000573

Classmate2:

I have read chapter 9 ” a little medicine and a little Beeb” in the chapter they discuss the sacrificing of animals for gran events. The family had sacrificed a cow for her return back home from foster care. They invited the whole family to celebrate the return of their daughter, in California they had passed a law which forbid the sacrificing of animals. This did not last very long they is many cultures in California who believe in Santeria and much sacrificing of animals is done. In my Hispanic family we have slaughtered animals before for a big family celebration. My dad for many years would make a pig for our birthdays, the delicious food we would eat that day. As the Lee’s used the whole cow and had a gran feast my family did the same with the pig the book mentions gathering family is difficult but offering food has always brought family together. 

 The Lee’s still had used money Leah was receiving from social security to buy the cow, it was purchased from a local farmer and was chopped up into small pieces to be able to fit into the floor of the car. The Lee’s placed the whole head of the cow in front of the house to welcome Leahs’s soul. In California the Hmong community was known for the sacrificing of animals and there was no problem one incident led to a house fire where a firefighter opened the fridge and saw a pig but spread lies that it was a cat. The rumor grew of hiding your pets or they would be eaten that is why the community had no overpopulation inf strays. In the chapter it discusses how Leah gained much weight due to the parents giving anything she wanted, even though being given a schedule the seizures had lessened but the Lee’s still did not want to follow the doctors’ orders when it came to Leah’s daily activities. 

Classmate3:

The chapter I read and will summarize was Chapter 13 – Code X. This was a hard one to read as most of the other chapters in this book- but its really telling of the undying love of the family . 

Some of the historical events that were described in this chapter was the account of the Lee’s recollection of being in a war and loosing three children in the span of three years. The realty that they faced with possibly loosing a child in this manner in such a sophisticated place such as the Children’s Hospital in Fresno , Ca was more tragic and emotional than having to leave Laos after the war .. where as the Lee’s said they dodged bullets, land mines and even walls of fire. Also for context, Lia has been in and out of the hospital, she has been n foster care and now she is back in the hospital in a comatose state. Non responsive and essentially in a vegetation state. 

The pain of watching their child die in front of them was unbearable, and they would not follow any medical orders that were given by the hospital. For example, it was New Years and the family wanted Lia to dress up for New Years Eve- and the staff (nurses and Drs) said she should not put on a jacket as they will need access to her upper body. The family did not comply and dressed up Lia. 

After this, the parents had it their mind they wanted to take her out of the hospital, even though the orders were being set up, and instructions were given to the family without an interpreter, the father would not wait a few more hours. He took her off her tracheal tube picked up her almost lifeless body and ran down the stairs with Lia in his arms. This is when the hospital alarmed a CODE X .. meaning there was a security breach. The Lee’s did eventually took her home, and when Lia left the hospital her temperature was 104 and when the Lee’s bought her home they washed her, and instead of dying like the drs and nurses told her she would, she thrived at home, and she made a gradual improvement. 

In the Hmong culture, you are not to give sick people medications, the instructions for the care at home were to give her medications- the mother, Foua, had no intentions on ever giving her any medications. 

Understanding cultural differences is a very important aspect of delivering health care to various populations who have immigrated to the United States from various parts of the world. Collaborating with others to explore these differences allows you to gather varying viewpoints on these differences and how they might impact health care delivery. 

Part I: Individual work

Select 1 chapter in The Spirit Catches You and You Fall Down that discusses Hmong history (Ch. 8 to 14) to read individually.

Write a 350-word summary of the chapter that includes the following:

·
Identify the historical events or cultural practices in your selected chapter.

·
Examine and describe how these differences create disparities between U.S. health care and the Hmong in California.

Share your summary with your team.

Part IA: Teamwork

Discuss as a team the key historical events or cultural practices you each found in your reading and summary.

As a team,
identify commonalities of Hmong history and cultural practices that recur throughout the chapters.

Create a list of 3 to 5 key cultural practices or factors that could impact health care program delivery to the Hmong community. Include a 2- to 3-sentence description to support your choices
.(All you need to do is come up with 1 key cultural with a 2-3 sentence description for this part)

Part B: Individual Reflection:

Write a 350-word summary explaining how the 3- to 5-key factors your team identified apply to the chapter you read. Describe how these factors impact the differences in disparities between U.S. health care and the Hmong in California.

Cite 3 reputable references to support your assignment (e.g., trade or industry publications, government or agency websites, scholarly works, or other sources of similar quality).

PART2::: DISCUSSION QUESTION

Visit the

Child Welfare Information Gateway
.

· What are the primary responsibilities of the health care industry in preventing child abuse and neglect, responding to child abuse and neglect, and supporting and preserving families?

· What circumstances should be present (or what considerations should be made) before removing a child from the guardianship of the parent?

Include sources/references to support your perspective.

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