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-Distribution of Refugees From Southeast Asia in 13 Western States*
Source publication
Healing is the alleviation of sickness, which includes both medically defined problems of pathophysiology (disease) and personal definitions of not being well (illness). Refugees from Southeast Asia now have a special need for healing because their health problems are changing from those of concern to public health, which are well documented and fo...
Citations
... In rural areas of Cambodia, people still depend on this traditional medical system for their healthcare, with an estimated 40-50% of the Cambodian population using TM [13]; however, nowadays, individuals are less likely to actively consult TM practitioner and will instead selfprescribe herbal medicine treatments [14]. Traditional Khmer Medicine (TKM) comprises four primary forms of care that include: providing medicinal bases, dermabrasive practices, maintenance of hot/cold ("yin/yang") balance, and supernaturalistic treatments such as spirit offerings [15,16]. Supernaturalistic treatments are prescribed by traditional healers (known in Khmer language as "Kru Khmer") or by Buddhist monks to treat the illnesses, which are believed to be caused by ghosts or spirits and are commonly related to Buddhist practices [17]. ...
Individuals across Cambodia depend on the use of natural products in Traditional Khmer Medicine (TKM), a traditional medicine system in Cambodia that has been practiced for hundreds of years. Cambodia is rich in fauna and flora species, many of which have been, and continue to be, traded domestically for traditional medicine use. Combined with other known exploitative practices, such as snaring for wild meat consumption and international trade in wildlife, domestic trade in wildlife medicine threatens populations of regional conservation importance. Here, we provide an updated understanding about how TKM is practiced in modern times; how TKM practices are transmitted and adapted; and roles of wildlife part remedies in TKM historically and presently. We conducted semi-structured interviews with TKM practitioners in Stung Treng, Mondulkiri Province, and at the National Center for Traditional Medicine in Phnom Penh, the capital of Cambodia. TKM is generally practiced in the private sector and is mostly informal, without enrollment in any academic training. TKM practitioner roles commonly involve collecting, preparing, selling, and advising on medicine, rather than providing direct treatment. Over half of the interviewed TKM practitioners (57.6%) were still prescribing wildlife parts as medicine over the past 5 years, with 28 species of wild animals reported. Lorises and porcupine were the wildlife products cited as being in highest demand in TKM, primarily prescribed for women’s illnesses such as post-partum fatigue (Toas and Sawsaye kchey). However, the supply of wildlife products sourced from the wild was reported to have dropped in the 5 years prior to the survey, which represents an opportunity to reduce prescription of threatened wildlife. We suggest that our results be used to inform tailored demand reduction interventions designed to encourage greater reliance on biomedicine and non-threatened plants, particularly in rural areas where use of biomedicine may still be limited.
... In rural areas of Cambodia, people still depend on this traditional medical system for their healthcare, with an estimated 40-50% of the Cambodian population using TM [13]; however, nowadays, individuals are less likely to actively consult TM practitioner and will instead selfprescribe herbal medicine treatments [14]. Traditional Khmer Medicine (TKM) comprises four primary forms of care that include: providing medicinal bases, dermabrasive practices, maintenance of hot/cold ("yin/yang") balance, and supernaturalistic treatments such as spirit offerings [15,16]. Supernaturalistic treatments are prescribed by traditional healers (known in Khmer language as "Kru Khmer") or by Buddhist monks to treat the illnesses, which are believed to be caused by ghosts or spirits and are commonly related to Buddhist practices [17]. ...
Individuals across Cambodia depend on the use of natural products in Traditional Khmer Medicine (TKM), a traditional medicine system in Cambodia that has been practiced for hundreds of years. Cambodia is rich in fauna and flora species, many of which have been, and continue to be, traded domestically for traditional medicine use. Combined with other known exploitative practices, such as snaring for wild meat consumption and international trade in wildlife, domestic trade in wildlife medicine threatens populations of regional conservation importance. Here, we provide an updated understanding about how TKM is practiced in modern times; how TKM practices are transmitted and adapted; and roles of wildlife part remedies in TKM historically and presently. We conducted semi-structured interviews with TKM practitioners in Stung Treng, Mondulkiri Province, and at the National Center for Traditional Medicine in Phnom Penh, the capital of Cambodia. TKM is generally practiced in the private sector, and is mostly informal, without enrollment in any academic training. TKM practitioner roles commonly involve collecting, preparing, selling, and advising on medicine, rather than providing direct treatment. Over half of the interviewed TKM practitioners (57.6%) were still prescribing wildlife parts as medicine over the past 5 years, with 28 species of wild animals reported. Lorises and porcupine were the wildlife products cited as being in highest demand in TKM, primarily prescribed for women’s illnesses such as post-partum fatigue. However, the supply of wildlife products sourced from the wild was reported to have dropped in the 5 years prior to the survey, which represents an opportunity to reduce prescription of threatened wildlife. We suggest that our results be used to inform tailored demand reduction interventions designed to encourage greater reliance on biomedicine and non-threatened plants, particularly in rural areas where use of biomedicine may still be limited.
... TCAM is often based in spirituality, including practices based on religious understandings of sickness and wellbeing such as seeking prayer from a Buddhist monk, or may be based in the somatisation of spiritual disturbances (Gilman et al., 1992;Lewis, 2007). In addition, beliefs related to disturbances of wind or temperature in the body may lead to traditional practices such as cupping, which serve to re-distribute or rid the body of excess air in the body that is understood to cause varying illnesses or ailments (Muecke, 1983). Herbal medicines are also common and passed down intergenerationally, particularly through older women (Brainard and Zaharlick, 1989;Gilman et al., 1992). ...
South-East Asian refugees have lived in the United States of America for nearly four decades, with early refugee immigrants experiencing ageing and later life within the refugee context. As refugees age, health concerns of this older population grow, highlighting the need for ongoing assessment of refugee health and health-seeking behaviours. This study builds on previous literature that assessed the health and health-seeking patterns of South-East Asian refugees in the early years following resettlement, exploring how health and health-seeking is understood among older refugees 40 years after immigration. This paper includes a subset of 37 older refugees from a larger, community-based participatory, mixed-methods intergenerational study of Cambodian and Laotian refugee families conducted over four years (quantitative N = 433; qualitative N = 183). Thematic analysis of 34 semi-structured interviews with these older refugees in coastal Alabama revealed trends in health and health-seeking practices. Older refugees reported high rates of diabetes and hypertension within their generational cohort, and indicated a shift in health-seeking behaviours, whereby Western biomedicine is sought first for such chronic concerns, followed by traditional medicines for mild ailments such as headaches or colds. Older refugees underscored barriers of language, finances and transportation as limiting access to Western health care. Implications for engaging in community health practices and incorporating services to specifically meet the needs of the ageing refugee population are discussed.
... The higher morbidity of the refugees demonstrated in our study can therefore be attributed to a range of variables including language barriers, which cause a delay in discharge due to the reluctance of medical staff to discharge children to parents who do not fully understand further instructions 8,12 . Another reason for delay may be that medical personal underestimate the capabilities of the parents to manage the care of their children in a community that lacks the nances for good ambulatory medical services ...
Background: The ongoing global refugee crises have raised concerns among medical communities worldwide.
Methods: We compared data from refugee and Israeli children admitted to the pediatric department (PD) at Wolfson hospital in Israel, between 2013–2017.
Results: 104,244 visits (0–18 years) to the pediatric emergency department (PED) were recorded. Admission rate to the PD for refugees was 695/2541 (27%) as compared to 11,858/101,703 (11.7%) for Israeli patients (P < 0.001). After matching for age groups (0–5 years), the hospital stay duration for the 0–2 years age was 3.22 (± 4.80) days for the refugees and 2.78 (± 3.17) for the local population (P < 0.03). For 0–2 year old children, re-admission rates within 7 days, were 1.3% for refugees and 2.6% for Israelis, (p < 0.05). Dermatological diseases (mainly impetigo and cellulitis) were more frequent in refugees (23.30% vs. 13.15%, p < 0.01), however, acute gastroenteritis and respiratory diagnoses were more common in Israeli children (11.72% vs. 18.52%, p < 0.05 and 6.26% vs. 14.84%, p < 0.01, respectively). Neurological diseases (mainly febrile convulsions) were also more frequent in Israeli patients (7.7% vs. 3%, P < 0.05). Very significantly, 23% of refugees had no health care coverage, while only 0.2% of the Israeli patients had no medical coverage (P < 0.001).
Conclusion: We found evidence for significant morbidity in refugees as compared to the local Israeli pediatric population, highlighting the need for tailoring different approaches to this fragile population.
Key notes
· The subject of refugees’ access to health care has been scantly studied so far even though refugees are considered to be a medically high-risk group.
· The results indicated a higher rate of hospitalization and morbidity in refugee patients.
· These findings highlight the need to tailor a specific approach to treating this population.
... The higher length of stay of the study group demonstrated in our study can therefore be attributed to a range of variables including language barriers, which cause a delay in discharge due to the reluctance of medical staff to discharge children to parents who do not fully understand further instructions 11,15 . Another reason for delay may be that medical personal underestimate the capabilities of the parents to manage the care of their children in a community that lacks the nances for good ambulatory medical services. ...
Background: The ongoing global refugee crisis has raised concerns among medical communities worldwide. Methods: We compared data from undocumented immigrant children and Israeli citizen children (ICC) admitted to the pediatric department (PD) at Wolfson hospital in Israel, between 2013–2017.
Results: 104,244 visits (0-18 years) to the pediatric emergency department (PED) were recorded. The admission rates to the PD for undocumented immigrant children was 695/2541 (27%) as compared to 11,858/101,703 (11.7%) for Israeli citizen children (P< 0.001). After matching for age groups (0-5 years), the hospital stay duration for the 0-2 years age was 3.22 (±4.80) days for undocumented immigrant children and 2.78 (±3.17) for the local Israeli citizen population (P<0.03). For 0-2 year old children, re-admission rates within 7 days were 1.3% for undocumented immigrant children and 2.6% for Israeli, (p<0.05). Dermatological diseases (mainly impetigo and cellulitis) were more frequent in undocumented immigrant children (23.30% vs. 13.15%, p<0.01), however, acute gastroenteritis and respiratory diagnoses were more common in Israeli citizen children (11.72% vs. 18.52%, p<0.05 and 6.26% vs. 14.84%, p<0.01, respectively). Neurological diseases (mainly febrile convulsions) were also more frequent in Israeli citizen children (7.7% vs. 3%, P<0.05). Very significantly, 23% of undocumented immigrant children had no health care coverage, while only 0.2% of the Israeli citizen children had no medical coverage (P < 0.001).
Conclusion: We found evidence for significant morbidity in undocumented immigrant children as compared to the local Israeli citizen pediatric population, highlighting the need for health policy changes on a national level to provide some sort of health coverage for all children.
... The higher morbidity of the refugees demonstrated in our study can therefore be attributed to a range of variables including language barriers, which cause a delay in discharge due to the reluctance of medical staff to discharge children to parents who do not fully understand further instructions 9,13 . Another reason for delay may be that medical personal underestimate the capabilities of the parents to manage the care of their children in a community that lacks the nances for good ambulatory medical services. ...
Background: The ongoing global refugee crises have raised concerns among medical communities worldwide.
Methods: We compared data from refugee and Israeli children admitted to the pediatric department (PD) at Wolfson hospital in Israel, between 2013–2017.
Results: 104,244 visits (0-18 years) to the pediatric emergency department (PED) were recorded. Admission rate to the PD for refugees was 695/2541 (27%) as compared to 11,858/101,703 (11.7%) for Israeli patients (P< 0.001). After matching for age groups (0-5 years), the hospital stay duration for the 0-2 years age was 3.22 (±4.80) days for the refugees and 2.78 (±3.17) for the local population (P<0.03). For 0-2 year old children, re-admission rates within 7 days, were 1.3% for refugees and 2.6% for Israelis, (p<0.05). Dermatological diseases (mainly impetigo and cellulitis) were more frequent in refugees (23.30% vs. 13.15%, p<0.01), however, acute gastroenteritis and respiratory diagnoses were more common in Israeli children (11.72% vs. 18.52%, p<0.05 and 6.26% vs. 14.84%, p<0.01, respectively). Neurological diseases (mainly febrile convulsions) were also more frequent in Israeli patients (7.7% vs. 3%, P<0.05). Very significantly, 23% of refugees had no health care coverage, while only 0.2% of the Israeli patients had no medical coverage (P < 0.001).
Conclusion: We found evidence for significant morbidity in refugees as compared to the local Israeli pediatric population, highlighting the need for tailoring different approaches to this fragile population.
... Discrimination, language barriers, acculturation, and poverty are some of the common impediments that contribute to higher rates of mental illness than in other clients (Anderson 1983;Maduro 1983;Muecke 1983;Sue and Morishima 1982). As compared with people born in the United States, individuals with low acculturation and limited English proficiency were only half as likely to seek mental health care (Snowden et al. 2007). ...
This chapter explores the ways in which emotion processing, in the form of words, images, and other stimuli, differs across a bilingual's two languages. Findings from the behavioural, physiological, neuroimaging, and clinical literatures support the notion of a bilingual's first language (L1) garnering emotion processing advantages and preferences. As a set, these works are discussed with regards to language proficiency and experience, particularly the domains of language dominance and learning environments. One common finding across physiological works is greater expression and activity when bilinguals activate and process emotional information in their L1, relative to their second language (L2). Common measures in these lines of investigation include facial electromyography (EMG) and skin conductance responses (SCRs). The chapter elaborates on the intricacies involved when working with bilingual clients, and differences in cognition and expression of emotion between L1 and L2 usage; the impact interpreters can have on healthcare outcomes; and culture‐specific treatment strategies.
... Fourth, some older Vietnamese Americans maintained traditional cultural health beliefs and practices, such as classifying food as "hot" or "cold," using food for healing, and adjusting portion sizes. These findings are consistent with the literature on Vietnamese traditional health beliefs and practices (Muecke 1983;Nguyen 1985). Most fruits and vegetables, with a few exceptions, are classified as "cold" (Muecke 1983). ...
... These findings are consistent with the literature on Vietnamese traditional health beliefs and practices (Muecke 1983;Nguyen 1985). Most fruits and vegetables, with a few exceptions, are classified as "cold" (Muecke 1983). From the "hot" and "cold" concept, many traditional practices have been developed to treat illnesses. ...
... In a survey by Jenkins and colleagues (1996), 65% of Vietnamese Americans believed that coin rubbing, eating rice porridge, and deep breathing of herbal vapors are best for treating a head cold. Western medicines are generally classified as "hot" and are perceived as very potent (Muecke 1983;Jenkins et al. 1996;Uba 1992). In one study, 17% of Vietnamese Americans believed that Western medicines are "too strong" for Vietnamese (Jenkins et al. 1996). ...
The purpose of this study was to better understand if a health educational presentation using culturally adapted materials was understandable and culturally appropriate, and that the content was retained, in an older Vietnamese American population. This study used cognitive interviewing. A convenient sampling was used to recruit eight participants by staff of a community-based organization from its client base. This is the first study to document that family eating style poses a challenge for estimating food intake among Vietnamese Americans. Participants who ate in a family eating style were not able to recall or estimate the number of servings of protein and vegetables. Some older Vietnamese Americans used food for healing and self-adjusted portion sizes from dietary recommendations. Cognitive interviewing is a useful method to improve comprehension, retention, and cultural appropriateness of health educational materials. Further nutrition research concerning intake measurement in ethnic groups that practice a family eating style is warranted.
... They were predominantly young, relatively healthy, well educated, urban dwellers; majority of family members had immigrated to the United States in family groups. The ''second wave'' of Vietnamese refugees, in comparison, was less educated, separated from family, and encountered more health problems as result of fleeing from Vietnam and encountering sparse resources while displaced in temporary refuge camps in Southeast Asia (Muecke, 1983). V.T.'s personal history of his family's exodus out of Vietnam via the refugee camp was consistent with those of the ''second wave'' refugee contemporaries. ...
The Asian American population is a fast-growing population, with enormous within-group heterogeneity. Although the past decade has seen significant gains in psychological research on this population, there continues to be notable paucity of research in some areas of clinical personality assessment with Asian American clients. This article provides guidelines for practical considerations in conducting clinical personality assessment with Asian Americans. It reviews recent research on the use of clinical assessment measures with Asian Americans and presents general guidelines for clinical assessment, followed by the case example of an Asian American client in a forensic assessment case. Some of the discussion is based on research on ethnic minorities and personality research on Asians overseas. The article also considers the use of the Minnesota Multiphasic Personality Inventory (MMPI) to assess the personality of Asian Americans. Finally, it looks at measures of Asian American psychological experiences, including acculturation, cultural values, and cultural conflicts.
... In another group hepatitis B was equated with Tuberculosis. Other research has noted Southeast Asian Understandings of the blood as a limited and non-regenerative quantity [31, 32]. Participants in our study noted that hepatitis B may be referred to as Rok (blood disease). ...
Cambodian immigrants are over 25 times more likely to have evidence of chronic hepatitis B infection than the general US population. Carriers of HBV are over 100 times more likely to develop liver cancer than non-carriers. Liver cancer incidence is the second leading cancer for Cambodian men and the sixth for Cambodian women. Despite this, this underserved population has received very little attention from health disparities researchers. Culturally and linguistically appropriate interventions are necessary to increase hepatitis B knowledge, serologic testing, and vaccination among Cambodian Americans. Eight group interviews were held with Cambodian American men (48) and women (49). Focus group discussion revealed unanticipated information about sociocultural influences on participants' understanding about hepatitis B transmission, disease course, and prevention and treatment informed by humoral theories underlying Khmer medicine, by biomedicine, and by migration experiences. Our findings reveal the value of qualitative exploration to providing cultural context to biomedical information--a formula for effective health promotion and practice.
