Shamanism Vs Western Medicine | hmong-presentation

The Role of the Hmong Shaman in Health Care
• Many non-Christian American Hmong continue to use Shaman along with Western health care methods.
• More traditional Hmong may choose to use a Shaman for a health care issue before going to a doctor or

Western health care professional.
• Shamans provide their services informally. Families may call upon clan leaders for help finding a shaman.
• A Shaman will attempt to diagnose the cause of illness and develop a remedy or cure.
• The remedy or cure will often involve the sacrifice of an animal. Non-Christian Hmong believe many illnesses

are caused by soul loss. The point of an animal sacrifice is to exchange the soul of the animal for the lost soul

of the ill person.

Traditional Hmong Beliefs about Health and Medicine
Source: Bruce Bliatout (1990). “Hmong Beliefs about Health and Illness.” Hmong Forum, 1:41-45.

Non-Christian Hmong believe that illness is caused by a wide variety of factors. Hmong beliefs about the causes of illness fall into 3 basic categories:
• Natural or Non-Spiritual Causes of Illness – The Hmong, like most other cultures, understand that many

illnesses are caused by naturally, either by the environment around them or by the natural processes of life

and aging
• Spiritual or Religious Causes of Illness – Ancestor, nature, and evil spirits are all thought to be able to cause

illness to people in certain cases. Unlike evil spirits, ancestor and nature spirits are perceived as being

non-harmful in general and to only cause illness in people they are offended
• Other Causes of Illness – This category includes a broad range of other types of perceived causes of illnesses. On example from this category involves curses. It is a common tradition Hmong belief that persons who have been wronged by another person have the power to curse the wrongdoer and bring about illness.

Traditional Hmong Beliefs about Health and Medicine

Source: Bruce Bliatout (1990). “Hmong Beliefs about Health and Illness.” Hmong Forum, 1:41-45.
Hmong believe that an important spiritual cause of illness results from an individual losing some of their souls. For a person to be in good health, all souls must be intact in the body.
Souls may be lost in a variety of ways including:
• Sudden fright (Ex: a dog barking scares a young child)
• Fear or too much grief
• Capture by an evil spirit
• A soul trying to transfer to another being because they are unhappy

Traditional Hmong Beliefs about Health and Medicine
Source: Dia Cha (2000). Hmong American Concepts of Health, Healing and Illness and their Experience with Conventional Medicine. PhD Dissertation, University of Colorado, Boulder.
Western Medical Practices that May Conflict with the Traditional Hmong Belief System
• Surgery – Many Hmong believed that surgery may interfere with reincarnation after they die and/or surgery

many open access to the body for evil spirits to enter
• Drawing Blood – Many Hmong feel that blood maintains balance in the body and that withdrawing blood will

weaken the body
• Autopsies – Traditional Hmong believe that an autopsy on a deceased person may hinder reincarnation. For

this reason, many Hmong believe they will have betrayed a family member if they allow an autopsy to be

performed. More broadly, Hmong also believe it is disrespectful to allow the body of their relative to be

dissected.

SHAMANISM VS. WESTERN MEDICINE

SHAMANISM VS. WESTERN MEDICINE

SHAMANISM IN U.S

Common Medicinal Herbs Used by Hmong-Americans
Source: J.L. Corlett et al. (2002). “Mineral Content of Culinary and Medicinal Plants Cultivated by Hmong
Refugees Living in Sacramento, California.” International Journal of Food Sciences and Nutrition 53: 117-128.

• Tshuaj Npuav Hniav = Achillea Millefolium (Milfoil, Yarro) – Used for cold sores, swollen gums
• Pawj Qaib = Acorus Garmineus (Aquatic Sword Grass, Chinese Sweet Grass) – cooked with chicken for the

mother following birth
• Ko Taw Os = Angelica (Angelica) – Cooked with chicken to help regain strength
• Hmab Ntsha = Basella Alba (Ceylon Spinach, Indian Spinach) – Cooked with chicken to alleviate arthritis, back

pain and as a general tonic
• Qhau Liab = Canna Indica (Indian Shot) – A remedy used for coughing, indigestion, stomachache and as a general

tonic
• Chais Qav = Crassocephalum Crepidiodes (Velvet Plant) – Used to treat heartburn and indigestion
• Ntxab Koob = Dendranthema Indicum (No English Name) – Cooked with Chicken, used as a general tonic and

to alleviate cough as well as externally to reduce bruising
• Ntiv = Eupatorium Lindleyana (No English Name) – Cooked with chicken, used as a general tonic, as well as

externally to treat feelings of weariness in arms and legs
• Kab Tsaus = Houttuynia Cordata (Fishwort, Nipple Grass, Stink Grass, Stink Peony)–Used to treat colds, coughs

and fever
• Lauj Vag = Hydrocotyle Javanica (Pennywort) – Used to treat coughs, edible but bitter taste
• Maj Qab Ntug = LeonorusArtemesia(Chinese Motherwort) – Used to relieve an upset stomach as a general tonic.
• Nruas Ntsev Nyeg = Oxalis Corymbosa (Violet Wood Sorrel) – Cooked with chicken; used to treat cough and as an external application to treat feelings of weakness in the arms and legs
• LuamLaws = Polygonum Odoratum (Knotweed) – Cooked with fish
• Qaub Nraug = Polygonum Runcinatum (Knotweed) – Used to reduce heartburn and indigestion
• Kuab Nplais Dib = Sedum or Sarmentosum (Stringy Stonecrop) – Cooked with chicken and a decotion, drunk to

relieve an upset stomach as well as for the external application to treat sores
• Txiv Iab = Solanum Pseudocapsicum (Jerusalem Cherry or MadieraWinter Cherry) – Edible but very bitter,

general topic.
• Nkaj = Strobilanthes (No English Name) – External application to treat bruises and headaches
• Pum Tshis Nyeg = Teucrium Viscidum (Germander) – Used to treat indigestion
• Kab Laug Zog = Verbena Officinalis (Verbena/Vervain) – Used to treat indigestion

Common Traditional Hmong Treatments
Source: Gerdner, L.A., Xiong, X., and Yang D. (2006). “Working with Hmong American Families.” In G. Yeo and D. Gallagher-Thompson (Eds). Ethnicity and the Dementias (2nd ed., pp. 209-230). Bristol, PA: Taylor and Francis CRC Press.

• Txhuav (Cupping) involves the application of a bamboo jar, glass cup, or animal horn to the skin to cause local

congestion through a negative pressure created by heat. Cupping is usually used to alleviate swelling and pain

(such as headaches, back and leg pain) and to also promote blood circulation
• Zaws Hno (Vigorous Massaging of the Stomach followed by Needle Pricking of the Fingers) is commonly used

to treat an upset stomach due to rapid food ingestion
• Diav Kav (Rubbing the Skin with a Sliver Spoon) is often use to treat flue and cold symtoms as well as stress-

related symptoms (such as headaches, muscle aches, and pain). In advance of the treatment, Tiger Balm is

applied to sooth the skin and increase circulation. Residual marks may appear for several days on the skin

surface where the rubbing occurred
• Npaws involves the vigorous pinching of the nasal bridge by using the thumb and the index finger. It is

commonly done to relieve headaches. The technique may leave a vertical mark on the nasal bridge.
• Zuaj ib Ce (Massage Therapy) is used for the alleviation of stress-related symptoms such as headaches, muscles

aches and other types of pain

Cancers and the Hmong Population
Sources:Mills, Paul K., Richard C. Yang, and Deborah Riordan. (2005). "Cancer Incidence in the Hmong in California, 1988-2000." Cancer Supplement 104(12): 2969-2974.Ross, Julie A., Yang, Xie., Kiffmeyer, William R., Bushhouse, Sally., and Leslie L. Robinson. (2003). “Cancer in the Minnesota Hmong Population.”Cancer 97: 3076-79.
• A California study of 1988-2000 state cancer registry data showed elevatedage-adjusted incident rates compared

to the overall population for hepatic, gastric, cervical, and nasopharyngeal cancers and for leukemia and

non-Hodgkin lymphoma among Hmong.
• A California study of 1988-2000 state cancer registry data showed lower age-adjusted rates among Hmong

population for colorectal, lung, breast and prostate cancers.
• A 2003 study showed that compared with all Minnesotans, the Hmong population had increased proportional

incidence ratios for nasopharyngeal cancer, gastric cancer and cervical cancer and decreased ratios for

prostate cancer, breast cancer, Hodgkin disease and melanoma.
• The authors of recent research studies advocate culturally sensitive education and screening programs for

Hmong populations in general but especially related to cervical, gastric, and nasopharyngeal cancers.

Food Handling and Hmong Prepared Foods
Source: Miguel A. Perez, et. al. (2006). “Food Preparation, Practices and Safety in the Hmong Community.”Hmong Studies Journal, 7:1-24.

• At cultural ceremonies and family gatherings, a whole slaughtered animal is used as a centerpiece, allowing a

Shaman or elder to perform a blessing. During the blessing, the slaughtered animal is left out at room

temperature for a couple of hours prior to preparation for consumption by volunteer food handlers. This

practice may provide a risk for pathogens related to foodborne illnesses.
• The consumption of raw laj (pronounced lahb), a traditional Lao dish found at many family events may also be

a threat to health, especially when left outside at warm temperatures. Lajis made from beef and or pork, and

may also contain pork skin and cookedchicken organs. Laj may also be served in the less risky, cooked form.
• Numerous documented incidents in the 1980s and 1990s of salmonella and food poisoning outbreaks in

California traced to raw lajbeing served at Hmong, Lao and Mien family events.
• There is a need for education in the Hmong community about the dangers associated with leaving out raw

meats for extended periods of time especially in warm temperatures for family and community events. A

California study showed only limited knowledge in the community of the potential threats associated with

these practices.

Diabetes and the Hmong Population
Source: Peterson, K.A., Vang, M.L., and Y.M. Xiong. (2003). "Type 2 Diabetes Mellitus in the Hmong Community." In Healing by Heart: Clinical and Ethical Case Studies of Hmong Families and Western Providers, Editors: Culhane-Pera, K.A., Vawter, D.E. et.al. pp. 176-182.

• No word for diabetes in Hmong, interpreters often use the term ntshav qab zib “or” sweet blood for diabetes
• Studies have shown that the Western lifestyle including a decline in physical activity and an increase in

high-carbohydrate, high-fat, low-fiber diets have increased the Hmong risk pattern for diabetes
• Practitioners who work with the Hmong clients have posited some generalizations about the traditional

Hmong diet which may help health professionals recommend diet changes for Hmong-American adults:
o Rice is a very common staple among Hmong families, long-grain rice is recommened for Hmong clients

with diabetes, it has less detrimental effect on blood glucose levels than short grain rice (including sticky

rice).
o In the U.S., the traditional Hmong of rice, boiled vegetables, limited meat and little salt is often altered to

include items much higher in fates, including fried vegetables, fried meat and lard
o A return to a more traditional Hmong diet, involving a reduction in frying and an increase in boiled

vegetables can lower saturated fat and caloric intake without strongly affecting the use of staple Hmong

foods

Working with Hmong Elders with Dementia
Source: Gerdner, L.A., Xiong, X., and Yang D. (2006). “Working with Hmong American Families.” In G. Yeo and D. Gallagher-Thompson (Eds). Ethnicity and the Dementias (2nd ed., pp. 209-230). Bristol, PA: Taylor and Francis
CRC Press.

• Some Hmong believe that dementia (tem toob in Hmong) has a spiritual cause and may call in a Shaman to

perform a healing ceremony. Researchers have found that the majority of Hmong do not see the value of

   seeking Western medicine for the treatment of elders with chronic confusion and memory impairment
• Some tips for health care providers working with Hmong Elders with Dementia
    o Avoid discussing important topics with the patient alone
    o Identify a family member and/or clan leader of the patient
    o Organize a family conference that includes an invitation to the clan leader
    o Discuss the important topics in a culturally and linguistically sensitive manner
    o Offer to include the clan leader in the decision making process
    o Be supportive of the family/clan leader’s wishes
    o Use a soft, gentle voice when talking to the patient
    o It is considered disrespectful for a stranger to rube or place their hands on a man’s head

Hmong Cultural Practices associated with Pregnancy
• Hmong believe a person is connected to the placenta (birth shirt in Hmong beliefs) for life
• Following birth, Hmong traditionally bury the placenta
• Traditionally, the placenta of a boy is buried beneath the main post of the house since it is considered the

connecting link to the ancestral spirits, and a son responsible for the spiritual obligations of the lineage. The

placenta of a girl is traditionally buried under the parent’s bed
• Hmong believe that at the time of death, the deceased collects the birth shirt (placenta) at the birthplace, and

with the proper performance of rituals the soul can find its way back to the land of darkness and eventual

rebirth back on Earth
• On the third day after birth, a soul-calling and naming ceremony is held, Hmong do not believe the child is

truly a person with a full complement of souls until this ceremony is held
• Traditionally, Hmong believe the new mother should stay at home to rest with the newborn child for thirty

(30) days following a birth
• Hmong believe the new mother should follow a special post-partum diet in the 30 day post-birth period. The

diet includes “hot” as opposed to “cold” foods.
• Hot foods in the post-partum diet include fresh hot rice, and chicken boiled with fresh green herbs. The

husband and/or mother-in-law will often cook these foods for the new mother
• The new mother and child are not encouraged to visit other households and in Southeast Asia, Hmong may

place a taboo sign outside of the home to warn others of the status of the mother and the newborn

Sources

Hmong Cultural Center- "Building Bridges: Teaching about the Hmong in our Community; A Health Care Providers- Focused Presentation http://hmongcc.org/BuildingBridgesHealthPresentation2007Version.pdf