Hmong

1
Hmong Health Care

• by
• Linda Meehl

2
Fathers History

• He was sent to America in 1977 after being in a
  neglected refugee camp
• He did not speak, write, or understand English
• Suffered torture in Laos before leaving. Nervous
  around those with any authority- real or
  perceived.

3
The Son

• He was born in the United States
• Speaks, reads, writes understands both
  languages

4
Case Story

• An 8-year old Hmong boy was hospitalized with a
  ruptured appendix. After surgery, the child
  complained of post-operative pain.
• The child's father requested an X-ray. An
  untrained interpreter communicated this request
  to the physician.

5
Case Story Continued

• The physician declined to order an X-ray and
  conveyed his rationale in a way the family
  perceived as disrespectful to the patient's
  father.
• The untrained interpreter became so emotionally
  involved that he and the physician exchanged
  angry words "eye to eye."

6
Barriers Solutions / Suggestions 1

• Barrier
• Not enough qualified interpretersfamily /
  friends may omit / change information presented
  to patient
• Solutions / Suggestions
• 1. Ensure that certified interpreters are
  available
• 2. Do not use family or friends of the
  patient

7
Barriers Solutions / Suggestions 2

• Barrier
• Provider and facility insensitivity to the
  linguistic needs of the Hmong patient sends a
  loud negative message to the ethnic communities
  about accessing health care
• Solution / Suggestion
• Cultural competency training for health care
  providers and administrators

8
Barriers Solutions / Suggestions 3

• Barriers
• Difficulties with trusting authority figures
• Solution / Suggestion
• 1. Add patients previous experiences with
  medical care to patients chart.
• 2. Explain in short, easy-to-understand terms
  what is happening and why.

9
Barriers Solutions / Suggestions 4

• Barrier
• Cultural misunderstandings / miscommunications
• Solution / Suggestions
• Patients need to work with medically trained
  interpreters and health care staff need to know
  the basics of other cultures to work effectively
  with them.

10
Barrier Solutions 5

• Barrier The father believes in the power of a
  shaman, a healer who goes beyond the capacities
  and expertise of physicians in the US health care
  system.
• Solution / Suggestion Offer the father the
  option of working with a shaman along with the
  traditional physicians.