The Hmong do not talk about death; this is one reason it stays in their hearts for so long. Death is not discussed because of the belief that spirits are all around, and if death is discussed, the spirits will hear it. The spirits will make other relatives sick and they’ll cause more death in the family. This belief has been part of the culture for so long it’s hard to eliminate it.


If a baby dies within three days after birth, no funeral is held for that baby. This is because the Hmong believe a baby has no soul until it is three days old, when the Shaman invokes a soul calling ceremony so a soul can be reincarnated into its body. American clinicians may have trouble dealing with this Hmong custom. They do not understand when a young couple whose baby has died says, “You do whatever you have to with it.”


Sharing bereavement experiences. My personal story.


I would like to share with you a little bit about my own life experience.


I never knew my father and was told by my Mom that he passed away when I was a baby, same as my Grandma. I never knew what they looked like or who they were. There were no pictures, either. So, it’s hard to imagine, but when I was around 14 years old I had a baby myself. No clinicians, no doctors to help me. I had the baby by myself.


At the age of 14, I suffered a great deal because my very first baby died when he was five months old. I felt it was my fault—I was too young and did not know. When my baby got sick, we went to the hospital in a bigger town—it was a long trip in a taxi. On the first eve- ning there, my baby looked different to me. I went to the nurse—she was Thai—and asked her to take a look at the baby. She said, ‘Your baby is already dead. I cannot help you. You waited too long to bring your baby in.’ She sounded like she was blaming me for it. I felt so bad already. I remember feeling like I was floating—I could not cling on to anything. So this baby’s death was devastating. I looked at the clinicians in the hospital, the families there, and everyone looked like mannequins to me, because no one understood me. No one could bring my baby back. Although it has been 25 years, I can still recall these feelings.


My advice to clinicians is that if you don’t know what to say, just give the patient and family a little time. Some general guidelines for interacting with Hmong are described in Table 1. And don’t be afraid to ask if there anything you can do to help. I know this is what Americans do best. Health care in the United States is more than gold to me.


After I came to the United States in the late ’70s, I had my second boy. In Hmong families, boys are considered more important than girls because boys are the ones who carry the fam- ily name and pass on family rituals. When I had my second son, I had excellent care from an Asian doctor. I could not talk with him because I did not speak English at that time. To this day, I still don’t know his name or nationality, but I remember that the health care I received was so much better than the care in my country. That’s why we need to learn from each other—so when we go home after a day’s work, we can say, ‘Yes, I’ve done my job.’


Finally, I had been working in health care for about 10 years, and I had seen families lose their child. One family cried as if their only child had died and they had many children at home. Allowing a soul calling ceremony for the families that are in this situation may help ease the fear and emotional pain.


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VOICES FROM THE COMMUNITY: CROSS CULTURAL EXPRESSIONS OF GRIEF AT THE LOSS OF AN INFANT


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