Two Cultural Worlds: Training Hmong Shaman and Western Doctors

Hmong were U.S. allies during the Vietnam War and many moved to the U.S. as part of the State Department's resettlement program beginning in the mid-1970s. The last wave of Hmong arrived in 2006, following closure of a large refugee camp in Thailand. There are more than 200,000 Hmong living in the U.S. today, with nearly 70,000 in Central Valley, California.

As with other immigrant groups, challenges and difficulties are encountered when providing adequate health care to those who come from markedly different cultures and belief systems. The Hmong consider the shaman to be their foremost healer and their trust in Western doctors is limited by tradition and negative experiences.

To integrate cultural and linguistic accessibility to health care, and in collaboration with Hmong community leaders, a program was undertaken to orient shaman to Western medicine. The premise was that mutual understanding of the practices of Hmong healing traditions and Western medicine will help provide respectful and effective health care and promote the acceptance of Western health care by refugees. The program goals were to reduce fear within the community and promote interactions that would help shaman and physicians understand how they could work together. Both shaman and providers were teachers and learners. Sessions included topics such as germ theory, and chronic diseases including diabetes, heart disease and stroke. Tours to the operating room, emergency department and radiology were facilitated. To date, 89 shaman have graduated from the training program and are permitted to visit Hmong in hospitals.