In 2000, the first Hmong interpreter/cultural mediator was hired to work with the resident doctors at the Family Residency Program at Mercy Medical Center Merced. Many residents were overwhelmed when they saw the thick chart of Hmong patients with chronic illnesses such as depression, diabetes, hypertension and chronic pain. Part of the problem was, they were unable to understand the patients' indirect communication style. It often takes longer for Hmong to communicate their health problems, because instead of answering a question with a 'yes' or 'no,' the Hmong patients give the whole story. This is especially true among the elders. For example, if a doctors asks a Hmong patient, "How long do you have this symptoms?" The patient's response may be something like, "Well, I had this problems since my father-in-law died, and that is when I had my second child. He is now 20 years old." The response could have been, "Twenty years."
The success rate for treating chronic illness is low because Hmong patients don't see chronic illnesses as something where you would need to take medication for as long as you live. So patients take medication until they start feeling better, then they stop the medications. Often when Hmong patients take the medication for a couple of months and it doesn’t immediately work, they often assume the medication didn’t work. Many times patients do not take the medication or do not take it correctly. Based on my experience as an interpreter, most patients who get more than five medications do not take it correctly. They either can’t read the label, or don’t know it by the name. So they go by the color and shape of the pills. But sometimes when medications look the same they don’t take it correctly. We had one patient who had been taking gout medication for ten years but his problem kept getting worse. We found out that he was rotating the three medications each day, instead taking each medication every day.
Many doctors asked me if there was anything they could do differently to support their Hmong patients. About 12 years ago, I suggested that we form a support group to do patient education about western medicine. Today, the Southeast Asian Support Group is still going strong. The group now has weekly sessions about how to take medication correctly. We also listen to each others' stories, answer questions, and do fun activities like doing stitch work, showing educational and entertaining videos, and playing games together such as bingo. The activities vary, but we always have a health topic to discuss each week. Many participants that came since the beginning are still coming to share their health concerns.
I interviewed two participants to see how well they thought the support group was working. Mai Xiong has been to the Southeast Asian Support Group since 2000. She was one of the few participant from the beginning.
"I can share and talk about my mental health and medical problems," Xiong told me. "I learned new home remedies from other participants. I feel better when I learn that others have similar or worse issues. I keep coming back so the facilitators can help me, such as make a doctor appointment or cancel an appointment."
Weun Chao Salee is a Mien participant; he has been coming to the group since 2001. "I am a widow," he said. "I don’t have anyone to talk to. Here in the support group, we share, we learn from each other, we watch Hmong movies together, we play games together, we update on news that impact our community. The activities that we perform here keep me from thinking about my challenged life. I learned that other people have problems too."