From doctors to shamans

health — By Bob Riel on October 9, 2009 at 7:20 am

It’s no secret that culture plays a role in health care, from our systems of medicine to our personal decisions. When a person receives health care in his or her home country, there are unlikely to be many clashes over culture because it’s a medical system that he or she knows and understand well. The United States is not a homogeneous culture, though, but rather one that attracts a regular influx of immigrants from around the world. Health care misunderstandings are more likely to occur when individuals or families from other cultures, particularly non-Western cultures, meet American medicine. So I read with interest this recent story about a California hospital that makes allowances for Hmong immigrants from Laos to receive treatment from a shaman as well as from a physician.

The patient in Room 328 had diabetes and hypertension. But when Va Meng Lee, a Hmong shaman, began the healing process by looping a coiled thread around the patient’s wrist, Mr. Lee’s chief concern was summoning the ailing man’s runaway soul.

“Doctors are good at disease,” Mr. Lee said as he encircled the patient, Chang Teng Thao, a widower from Laos, in an invisible “protective shield” traced in the air with his finger. “The soul is the shaman’s responsibility.”

At Mercy Medical Center in Merced, where roughly four patients a day are Hmong from northern Laos, healing includes more than IV drips, syringes and blood glucose monitors. Because many Hmong rely on their spiritual beliefs to get them through illnesses, the hospital’s new Hmong shaman policy, the country’s first, formally recognizes the cultural role of traditional healers like Mr. Lee, inviting them to perform nine approved ceremonies in the hospital, including “soul calling” and chanting in a soft voice.

The policy and a novel training program to introduce shamans to the principles of Western medicine are part of a national movement to consider patients’ cultural beliefs and values when deciding their medical treatment. The approach is being adopted by dozens of medical institutions and clinics across the country that cater to immigrant, refugee and ethnic-minority populations…

A recent survey of 60 hospitals in the United States by the Joint Commission, the country’s largest hospital accrediting group, found that the hospitals were increasingly embracing cultural beliefs, driven sometimes by marketing, whether by adding calcium- and iron-rich Korean seaweed soup to the maternity ward menu at Good Samaritan Hospital in Los Angeles, on the edge of Koreatown, or providing birthing doulas for Somali women in Minneapolis.

By the way, if the story of Hmong immigrants dealing with American doctors sounds vaguely familiar, that’s because it was also the subject of an excellent book about 10 years ago, called The Spirit Catches You and You Fall Down. If you’re at all interested in cross-cultural topics, especially as they involve health care, you should check out the book.