464


SECTION 9 Southeast Asia


Te Hmong people practicing traditional religion believe


three souls reside in the body, but one or more can move in and out of it, depending on the balance and harmony among the souls. Upon death, the souls take three routes: one goes with the ancestors, one stays in the body, and one goes to the spirit world. Although the Hmong people recognize natural and physical causes of sickness, they attribute most illnesses to problems in the spirit world. Disharmony with the spirit world results in the loss of one or more of the individual’s three souls. Tis loss results in a range of afflictions, such as pain, depression, headaches, vomiting, rashes, and infertility.26-28 Te traditional system of dealing with sickness involves several types of healers26-28


:


• Shamans (tus txiv ua neeb): A shaman is a person who is “chosen” (yuav ua neeb) as a spiritual healer, usually follow- ing a serious illness. Tey serve as a mediator between a Hmong person and the spirit world, performing healing ceremonies and negotiating with spirits by using spirit money or exchanging an animal soul for a human one.


• Soul callers (tus hu plig): A soul caller is a person who calls the lost soul and returns it to the body in a soul-calling ceremony that involves chanting, the burning of incense, and offerings of food. One learns the practices from other soul callers.


• Magic healers (tus ua khawv koob): Tese healers are not “chosen” ones. Tey use magic incantations to treat nonspiritual illnesses.


• Herbalists (kws tshuaj): Herbalists treat nonspiritual illnesses and have knowledge of medicinal plants.


Western medicine practitioners may choose to view sha- manism as positive therapy to counteract anxiety and other psychic or psychosomatic disorders. Understanding and appreciating the value of Hmong shamanism by clinicians and health care workers can help improve holistic healing practices.29


Some health care systems have embraced the


value of shamans by encouraging hospitals to call shamans and welcome them into the hospital setting when patients are experiencing symptoms that they believe a shaman can help with. Tis facilitates and establishes trusting relation- ships between shamans and other health care professionals.30 Te Hmong people define a serious illness as a condition


that renders the individual incapable of eating, drinking, or getting out of bed.27


An individual who can still function, even


Jackfruit is a large tropical fruit with flesh that can be eaten ripe as a sweet fruit or dessert or used unripe as a meaty ingredient in savory dishes.


at a low level, is considered to be only mildly ill. Tus, Hmong people may not seek medical attention until they are very ill by Western standards. Tere may be perceived mistrust of West- ern medicine, which may be related to a lack of understanding or familiarity with Western medicine as well as the culture and traditions of Hmong people.31


In other cases, Hmong people


may seek care from both physicians and shamans, believing that there is a distinct difference between a physical cause and the spiritual cause of an illness, seeking both biomedical and traditional healing practices with recognition that these practices have their own value, role, and timing.32,33


Younger


Hmong Americans are typically more comfortable with West- ern medicine; although as caretakers of older adults, younger caretakers generally respect the preferences of the older adult’s traditional healing practices over their own preferences.


Herbal and Alternative Remedies Although it is well documented that Hmong people use herbs for the treatment of health problems, specific herbs are not usually identified. Specific home remedies in the treatment of illness have not been described adequately in medical research, but researchers have recently documented Hmong medicinal plant knowledge and usage.34 Herbal medicines can have nutritional effects as well as medicinal properties, with researchers finding that medicinal herbs grown in urban gardens in California contributed minerals such as calcium, zinc, and iron to the diet.35 Hmong people believe that Hmong herbal medicine works


Some


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