The concern is that the issue of healthcare for culturally diverse individuals is so complex, there are no exact rights and wrongs. For example, in Fadiman's book, no person(s) can be said to be ultimately correct or incorrect in his/her behavior or actions; everyone did what he/she thought was right. In order to help others who have different cultural backgrounds and experiences, as the Hmong, it is essential to be 1) proactive. That is, to forecast the transforming demographics in the U.S. over the coming decades and put plans into place that will best serve these individuals and 2) collaborative. The best results occur when professionals from different backgrounds and expertise share best practices and learn from each other. What could have happened, for example, if the hospital, social workers or CPS would have called for a multicultural collaboration of individuals from both the Western and Hmong societies? Chances are that Lia's tragedy would have occurred no matter what, but she would have had a better chance for a good life. Collaboration resolves other problems, as well. First, by joining together, there is the possibility of getting additional funding or sharing the cost of needed services, such as translators. Second, through collaborative measures, the various services can share their areas of expertise and reduce or eliminate waste and duplication of services. Third, there is a better chance of offering well-rounded services where people do not fall through the cracks.
Culturally effective healthcare must also be tightly integrated into all levels of education...
Yet the nightmare continued, because the communication problems were not resolved. During the next four years, her anticonvulsant medicines were changed about 25 times, which would have been hell for any family. The Lees questioned the value of so many prescriptions, especially with their Hmong mindset, and did not follow directions. Of course, this was exacerbated by the fact that they did not understand the dosages. The doctors inaccurately concluded
Then, if the parents did not listen to the doctors, they assumed more of the responsibility of what happened. How could the doctors expect the medicine to be taken correctly when the parents did not read, did not know mathematical symbols and were given change after change. They were blindsided by their own diagnosis and the arrogance that everyone would follow their treatment exactly. Nor can the doctors be
To a culture that didn't use calendars, giving a certain medicine at a certain hour of the day was incomprehensible. Neil and Peggy didn't consider that a somewhat less effective, but easier-to-follow drug regimen may have been better given the state of affairs. Instead, the Western idea of doing as much as medically possible for as long as medically possible prevailed. When Nao Kao and Foua failed to comply,
Spirit Catches You and You Fall Down I believe Anne Fadiman was trying to prove that it is possible to work through tough cultural barriers by showing the mistakes of Lia Lee's doctors. By showing these examples, and also giving examples of how culture can work together, Fadiman is trying to prove that the American medical system needs to have other socially accepted avenues of therapy to work alongside of
Medical training is all about treating patients who understand, there is little training for the patients who are not "normal," and so the medical community is ill prepared to deal with other cultures. The American doctors were saddened by Lia's condition, which deteriorated to a vegetative state after a two-hour long seizure, but they never took the time to understand how to really communicate with the Hmong. Even the
Spirit Catches You and You Fall There were a number of different delivery systems models in place and which attempted to effect positive care for Lia Lee and her family in Anne Fadiman's The Spirit Catches You and You Fall Down. One can successfully argue that more than one model was used throughout the duration of the book for the simple fact that there were a number of barriers preventing
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