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Question Description

I’m working on a nursing discussion question and need an explanation and answer to help me learn.

A. What role does Hmong Culture play in Lia’s health condition and how does it collide with American Medicine?

B. Describe a folk medicine practice you have witnessed in your nursing practice.

CASE STUDY: The book titled The Spirit Catches You and You Fall Down, by Anne Fadiman, tells a story of Lia Lee, a Hmong child with epilepsy, who lived in Merced, California. When 3-month-old Lia Lee arrived at the county hospital emergency room in Merced, a chain of events was set in motion from which Lia, her parents, and her doctors would never recover. Lia?s parents, Foua and Nao Kao, were part of a large Hmong community in Merced, refugees from the CIA-run ?Quiet War? in Laos. Her parents and doctors both wanted the best for Lia, but their ideas about the causes of her illness and its treatment were very different.

The Hmong see illness and healing as spiritual matters that are linked to virtually everything in the universe, but the U.S. medical community marks a division between body and soul and concerns itself almost exclusively with the former. Lia?s doctors attributed her seizures to the misfiring of her cerebral neurons; her parents called her illness ?qaug dab peg? ? the spirit catches you and you fall down ? and ascribed it to the wandering of her soul. The doctors prescribed anticonvulsants; her parents preferred animal sacrifices. The Spirit Catches You and You Fall Down moves from hospital corridors to healing ceremonies, and from the hill country of Laos to the living rooms of Merced, uncovering in its path the complex sources and implications of two dramatically clashing worldviews.

Lia?s doctors prescribed a complex regimen of medication designed to control her seizures. However, her parents believed that the epilepsy was a result of Lia ?loosing her soul? and did not give her the medication as indicated because of the complexity of the drug therapy and the adverse side effects. Instead, they did everything logical in terms of their Hmong beliefs to help her. They took her to a clan leader and shaman, sacrificed animals, and bought expensive amulets to guide her soul?s return. Lia?s doctors believed that her parents were endangering her life by not giving her the medication, so they called child protective services, and Lia was placed in foster care. Lia was a victim of a misunderstanding between these two cultures that were both intent on saving her. The results were disastrous: a close family was separated, and Hmong community faith in Western doctors was shaken.

Lia was surrounded by people who wanted the best for her and her health. Unfortunately, they involved parties disagreed on the best treatment because they understood her epilepsy differently. The separate cultures of Lia?s caretakers had different concepts of health and illness.

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