Before coming to the United States, Hmong relied on shamans and herbalists to treat their illness. Access to western medicine was limited. But here in the U.S., Hmong seeking medical care is still a last resort. Many believe that an open incision will increase the chance for evil spirits to make a person sicker, so they don't trust the western practice of performing surgery on patient. Blood and organ donations are also not common because many Hmong believe that missing body parts will contribute to birth defect in the next life. These cultural differences, as well as language barriers and lack of patient educations, are barriers to good health in the Hmong community.
In 2000, Merced's Healthy House Within A MATCH Coalition received a grant from The California Endowment to begin a project that had never been done before: start a program to bridge the gap between Hmong shamans and the mainstream culture of western medicine. The program, called Partners in Healing, provides training for doctors at Mercy Medical Center Merced and Hmong shamans so they better understand each others' cultural and medical practices. The program also provides a space for Hmong shamans to get together and share their ideas and practices. The shamans are cultural experts and healthcare providers are medical experts. Both sides are teachers and learners.
The goal of Partners in Healing is to fill the gap between the Hmong culture and western healthcare systems. Hmong shamans are considered to be honest and spiritual leaders in the Hmong community. There are 112 Hmong shamans who have participated in the program so far.
Recruiting Hmong shamans to attend the training is very difficult tasks. Hmong people have been through lots of political turmoil where the end result was not the same as what was promised to us. For example, during the Secret War the Hmong were promised to be protected, but when the CIA withdrew in 1975, the Hmong were left behind facing persecution. So not surprisingly, not all shamans want to participate. One shaman told me, “The more American learns from us the less they are going to let us practice our traditions.”
But many shamans do participate. At the end of the second year of the training, we had to increase the number of group participants due to a long waiting list. The training consist of medical professionals discussing topics that range from anatomy and medical terminologies to mental health and how to use ambulance services. Hmong shamans learn more effectively through this kind of observation and participation. We use pictures, body models, demonstrations, and in-person tours to support the training.
On the other hand, the healthcare providers also learn by observing shaman ceremonies at the shaman’s home. The providers learn how shaman is chosen and trained, the Hmong culture and belief, the difference level of shaman treatments and their specialty.
Because of the language and cultural barriers, liaisons are needed to bring the shamans and the doctors together. Ideally, the Hmong liaisons work as community leaders and speak both dialects of the White and Blue Hmong and Lao, because some medical terms are borrowed from the Lao language. Trust is very important so the liaisons have to be someone whom well known in the Hmong community. The liaisons also serve as an interpreter. Without a good liaison, the project can’t run.