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Understanding The Hmong

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This is Phillip Periman in Amarillo giving listeners a taste of what we are reading in the HPPR readers’ book club this spring. Anne Fadiman’s non-fiction narrative story of the cross-cultural conflict between a Hmong family whose baby girl has a seizure disorder and modern western medicine came out in 1997. Her title came from the Hmong name for the illness qaug dab peg(kow da pays) which translates: “The Spirit Catches You and You Fall Down”.

The story cannot be understood without understanding the Hmong. Fadiman goes to great length to educate the reader in Hmong history and culture. The chapters in her book alternate between revelations about western medicine and Hmong life. Early in the book (chapter 6) Fadiman recounts her dilemma of where to place the hundreds of pages she accumulated for her book. Should she put the information in the Medicine folder, or Mental Health, or Animism, or Shamanism, or Social Structure, or Body/Mind/Soul Continuum. She realized for the Hmong “Medicine was religion. Religion was society. Society was medicine.” Economics, too: one could not buy a pig much less a cow for sacrifice without money.

Yes, right there in Merced, California where in the 1990s the Hmongs became more than 15% of the population, they continued their centuries old practices of animal sacrifice. The Hmong resisted, even rejected American medicine with taboos against the routine practices of blood tests, surgeries, anesthesia, and autopsies because in the Hmong’s view illness was not a limited specific event but a sign that their entire universe was out of balance. As Fadiman wrote, “The Hmongs carried holism to its ultima Thule.”

Who were the Hmongs and why did they come to the USA? For thousands of years, they existed without being a separate country in southwestern China as an independent ethnic group. When the Chinese began to impinge on their territory four hundred years ago, the Hmongs moved into Laos, Thailand, and neighboring countries. As a collective society, they never fled, but carefully carried the elderly and the young to safety first. Usually, they moved up mountain to land no one else was willing to farm. The Hmongs found a way to sustain their communities. The Hmongs had no written language and passed their culture orally. They were animist who believed in spirits both good and evil that had to be appeased by music and animal sacrifice. While they were paternalistic, they were more strongly collective meaning they stuck together and supported each other through a clan structure.

Many Hmongs resided in Laos at the time of the Viet-Nam war. Consequently, they were recruited and trained by the CIA to fight in the secret war against the Viet-Cong with promises of US protection if the war went the wrong way, which it did. Thousands of Hmongs had to flee into the refugee camps of northern Thailand. After many years 90% of them managed to migrate to the US. Initially through church agencies who received the US government contracts to support them. Later, because of the tight clan structure of Hmong culture, by communities of Hmongs in California and Minnesota.

The Lee family came to California from the refugee camp in Thailand Lia, the subject of this book, was their first child born in a hospital and not on the dirt floor of a traditional Hmong home. Her first seizure would occur three month later in October 1982. At age five she would have the “big one” that left her brain damaged and vegetative. Lia was sent home with her parents expected by the physicians to die. However, she lived for twenty-six more years, dying only in 2013 at age 30. Her medical history and this book, The Spirit Catches You and You Fall Down” are now part of many medical schools’ curriculum.

This has been Phillip Periman in Amarillo for the readers book club.