It is imperative for health care to take into account the intricacies and genuine misgivings of different cultures towards popular western medicine. Though the allopathic medicine and surgery are universally accepted, there are in practice, several alternative and culturally unique cure systems. These systems might not have the benefit of universal acceptance, but within their limited cultural spheres of influence, they have a strangle hold. For example, in her native setting, (though it might arguably be an exaggeration) “She remains proud to this day that she delivered each of them into her own hands” (Fadiman 1).
Therefore, any medical intervention that does not take into consideration, the unique skepticism or peculiarities of the community, which is being treated, has every chance of being rejected. Any such rejection has two distinct disadvantages for all concerned. Any failure of the medical care will only be used to continue the perception of being alien and therefore, ineffective. It also diminishes the competence of any culture to make the newest entrants into its fold feel welcome and well cared for.
It is in fact a seldom thought about principle. Even restaurants have Kosher and Jain sections to take care of special cultural needs. It is a sad commentary to note that Medical centers which are far more important than eateries do not take adequate care to reassure or eliminate the reservations rooted in the unique traditions of their parent culture. But as Slawomir Magala mentions in his book Cross-cultural Competence “(diversity is perceived as a challenge and a chance, not a threat)” (Magala 2)
Anne Fadiman’s depiction of Lia Lee’s tragic story is more a commentary on the clash of different cultures in the most multi-cultural of nations, the United States. Though there is ample evidence of romanticizing the culture or the race – Hmongs, it serves to provide a counter point to all that is considered natural and normal in an American society. The inherent suspicion towards anything new and the lack of trust that comes to the fore when a new value system strikes very near home forms the crux of the story. Medical science is something that borders on trading in miracles to people who are not in the know.
Besides, to most laymen, Doctors or medical practitioners are next only to God, when they are able to cure their dear ones and even lower than an evil spirit, when they are not. It is not uncommon in most primitive cultures to have medical practitioners or pretenders to that effect, to be equated to God’s incarnations. This coupled with the propagation of age old beliefs without ever questioning their scientific basis generally fosters distrust in cultures that are not exposed to modern medicine, when confronted with a medical emergency.
It is nothing to be belittled. Even most pragmatic and advanced of societies still do not have 13th floor in many buildings. Urban legend, superstition or by any other name, it is a manifestation of blind ritualistic belief. The aversion displayed by most cultures to the prescriptions and practices of modern medicine are to be viewed in the same context. Any belief system that has been carried over for ages gradually etches itself on the subconscious of the believers that it is very difficult to wean them away from these beliefs.
If Lia’s parents were reluctant to administer the medicines in the dosage prescribed, it is a manifestation of this conflict between their age-old beliefs and modern reality. As experts readily agree today “ The roles of various family members in health care decisions and interventions are influenced by cultures” (Srivastava 82). Besides, Hmongs, subject to a series of displacement both cultural and geographical might feel it as abandoning one’s own roots when they are confronted with a choice between an alternate value system and their own traditions carried over from a different age and a different place.
Fadiman’s moving narrative masks the fact that it is not an unusual happening in any multi cultural environment that the cultural competence does not enable life and death issues (literally, as well as figuratively) to overcome cultural differences. The case of Lia Lee might have a lot more drama and gut wrenching pain and suffering that makes the story unique. But it brings to attention, though subtly to the fact that even if the circumstances were not so poignant, and the narrative so moving, yet they are a million more such stories untold that occur every day in various places where inter-cultural interaction take place.
If one can imagine a scenario where the protagonists involved were not the stoic parents, nor the culture the valiant Hmongs with a long history of valor, the doctors not those dedicated practitioners of Hippocratic oath, nor the situation one involving the tragic death of a young child, still it is possible to see cultural barriers affecting the interaction of any particular society. Looking back at the story of Lia Lee which happened in the 1980s, it is heartening to see that, today, such barriers between cultures are few and far between.
However, there is no denying the numerous efforts in health care with a special attention to substance abuse and mental health to increase the cultural competence of practitioners. In his book Teaching Cultural Competence in nursing and Healthcare, Marianne. R. jeffreys says educators everywhere are additionally challenged to learn how to effectively lead the quest for culturally congruent health care by implementing creative, evidence-based educational activities that promote positive, cultural competence learning outcomes for culturally diverse students and health care professionals.
(3) Globalization has had a lot to do with this wider acceptance of western culture than any genuine effort from various cultures to imbibe the best of others. To put it more bluntly, American mainstream culture has not done a great deal to adapt or to be sympathetic to any foreign culture. It is the gradual effect of globalization and the inevitable familiarity with the cultural mores which have made other dominant cultures of the world more receptive to the value system of the developed countries.
Though it is easy to conclude that today’s society is better equipped to handle such culture competence issues, it is not valid. The flight of Hmongs to USA necessitated them to assimilate the American culture and the fact that they have done that seamlessly in the last couple of decades is the proof that it is difficult to distinguish Hmongs in the American cultural fabric today. They have integrated themselves, in spite of their vastly different culture.
But if there is another situation similar to Laos today comprising a totally different culture and the future course of actions warrant a sizable population of that culture emigrate to US of A, their plight would be similar(almost) to what Hmongs and many other cultures before and since, have endured in the great American scheme of things. There has never been any concerted effort in this society to understand and accept other cultures.
“A frequently proffered reason for the lack of attention to cultural competence is the “homogenous nature of the managed-care population. ”(Mandersheld 41). The question of whether it is the supreme arrogance of our culture can be argued endlessly. But with this touching story Fadiman does mange to bring this issue into the public consciousness more effectively than any other effort before or since. Works cited Fadiman, Anne. “The Spirit catches you and you fall down.
” New York: Farrar, Straus & Giroux, 1998. Magala, Slawomir. “Cross-cultural competence. ” New York: Routledge, 2005 Srivastava, Rani. “ The healthcare professional’s guide to clinical cultural competence. ” New Delhi: Elsevier Health Sciences, 2006 Jeffreys, Marianne. R “Teaching Cultural Competence in nursing and Healthcare. ” New York: Springer Publishing Company, 2006 Mandersheld, Ronald. W. “ Mental Health, United States, 1996”. Pennsylvania: DIANE Publishing, 1998