ing her fill out the papers, the provider can casually ask, “How are you doing? How are things at home? Is your mother-in-law supportive? Do you have any friends you can talk to?” The provider can extend the contact by completing only part of the task at each visit. For example, she can ask the mother to make a copy of a certain paper and bring it back another day. This gives the mother a valid reason to return and talk further. Thus, providers have to take an indirect approach to counseling bereaved Chinese mothers.
Service providers face several challenges in providing support to grieving Chinese par- ents. Their reaction may seem unusual or even inappropriate to Westerners. Several cultural factors may affect the grief response:
• the Chinese belief in the natural way, or fate • the tendency to hide emotions and avoid behaviors than may cause a loss of face • the greater value placed on males compared with females • the lack of funeral rites or respect for children in the Chinese culture • the possibility of being blamed for the child’s death • a lack of support by family members • language barriers • negative attitudes about mental health counseling services
Hmong beliefs and traditions. (Based on a presentation by Nancy L. Vang)
History and culture. The Hmong people and culture. The word “Hmong” is an ethnic tradition, rather than a race or national origin. There are an estimated 12 million Hmong in the world. About 9.7 million live in mainland China, 1.2 million in Vietnam, 400,000 in Laos, 300,000 in Thailand, 300,000 in the United States, and 100,000 in Myanmar (Lao Human Rights Council, 2000). There is a substantial Hmong population in France as well. Until recently, most Hmong people lived in the mountains of Southern China, Laos, Thailand, and Northern Vietnam. The Hmong people in the U.S. mainly came as refugees from Laos. The Asian Hmong culture is agrarian with religious beliefs based in animism including the use of shamans for guidance, healing, and other ceremonies.
The Hmong of Laos carried out U.S. military objectives in Southeast Asia from the 1950s through the 1970s. Once the United States pulled out of Vietnam, the North Vietnamese and the Communist government in Laos marked the Hmong for geno- cide. Many died or fled to the United States or refugee camps in Thailand. Starting in 1991, Thailand began a forced repatriation of the Hmong from their refugee camps back to Laos, where atrocious human rights abuses continued. Some of these Hmong refugees were able to emigrate to the U.S. In December 2003, the United States State Department agreed to resettle up to 15,500 Hmong from Thailand’s last refugee camp. The largest number went to California and the second-largest to Minnesota, which already had an established Hmong population.
VOICES FROM THE COMMUNITY: CROSS CULTURAL EXPRESSIONS OF GRIEF AT THE LOSS OF AN INFANT 37
RECOMMENDATIONS FOR SERVICE PROVIDERS:
• Do not routinely rely on con- ventional support groups, bereavement groups, or coun- seling, for parent support.
• Give the mother a practical reason to visit, such as fill- ing out paperwork.
• Integrate counseling with the completion of a task such as signing papers.
• Extend the task over several visits to give the mother a reason to return and talk some more.
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