Transforming the Refugee Experience

Next month begins my 16^th year as President of the Board of Directors for my community’s Refugee Development Center, so I assigned myself a personal “refresher course” of several readings which together have served to remind me of refugee “waves” during the late 20^th and early 21^st Centuries that exposed issues which, in many cases, refugees continue to face today. For example…

The Spirit Catches You and You Fall Down – A Hmong Child, Her American Doctors and the Collision of Two Cultures is an insightful work of non-fiction by Anne Fadiman. It is a skillfully presented story which would have been more pleasant reading if the ending had not already been known to me, was not true, and was not so damn heartbreaking. The sad story is presented in chapters that alternate with others that describe the Hmong experience in Laos and for the 100,000 Hmong refugees to the United States during the 1980s…an anthropological and sociology tutorial that doesn’t overlook America’s initially secretive and mostly shameful episode in Southeast Asia, which actually helped to create the situation that necessitated that Hmong escape from Laos.

There’s much to learn here…about the “Quiet War” waged in Laos alongside the notorious Vietnam War…about Hmong history, culture, traditions and beliefs…about the tragedies of refugee camps and the travails inherent during the resettlement process, which were greatly exacerbated in the case of Hmong…about the limitations of Western medicine, and yet its arrogance…about the nature and treatment of epilepsy…about the unlimited compassion of some people and the callous incompetence of others…about the lack of clarity by medical providers, the “dense fog of  misunderstanding” by non-English speaking patients, and the worst of consequences when there is a breakdown of communication. Made evident here are contrasting views of medicine: in Hmong culture there is an unscientific but wholistic approach, while American medicine is said to be a slave to science and “the practice of medicine has fissioned into smaller and smaller sub-specialties, with less and less truck between bailiwicks.” 

This is a story about the 1980s written in the 1990s that I’ve read at the end of 2023; so, I know that much has changed…in fact, the author says as much in an “Afterword” added 15 years later in which she notes that the ill-prepared Merced, California hospital of the 1980s had by 2012 become, with its partnering social service agency, a model for programs across the country. Tragedy can be transformative.

The author describes how nomenclature has evolved over the years, noting that the term of art for what has been in too short supply in refugee service agencies has evolved from “cultural competency” to “cultural humility.”  Just days before I read this book, I attended the monthly staff meeting of our community’s Refugee Development Center, during which it was explained that all of its teams address cultural humility on a regular and on-going basis; and then we all participated in a cultural humility awareness exercise before we talked about the myriad programs and services and the record numbers of youth and adults in the community who are accessing those offerings.

 It is gratifying to know that, both in what it does and how it does it, this home-grown non-profit organization is providing international newcomers to the community with what they need to know about American systems, without having to forsake their native souls. 

JER