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Preface and Acknowledgments
- Vanderbilt University Press
- Chapter
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xi Preface and Acknowledgments This is a book of stories—stories of Hmong people’s anguish, suffering, desire, struggles,and successes as they have sought compassionate health care.Refugees from the Vietnam War in Laos, the Hmong came to the United States believing they would receive excellent health care from doctors and nurses. Sometimes they did. But often they encountered disagreement, conflict, and disrespect. These are the stories of their experiences and also the stories of their U.S. health care providers. This book is filled with insights into demonstrating respect and building trust across cultures—in short, about healing by heart. In the mid 1990s health care professionals were expressing deep concern that they were failing in their relationships with Hmong patients and families. They wanted to better understand traditional Hmong health beliefs and practices and to learn how to develop more respectful, trusting, and satisfying relationships with Hmong patients and their families. Thus, the Minnesota Center for Health Care Ethics, inspired by its mission“to explore the perspectives that diverse faith and cultural traditions bring to health care decisionmaking” and its partner organizations’ shared commitment to social justice, set about, under the leadership of Dorothy E. Vawter, to develop and sponsor several collaborative projects with the Hmong community. The strategy, with foundation and private support, was to invite Hmong health care providers and leaders to meet regularly with the Minnesota Center to decide what information was most important to convey to U.S. health care professionals. Barbara Babbitt made the first overtures to English-speaking leaders in the Hmong community and invited them to consider whether a collaborative effort could improve health care for Hmong patients. She assembled a core group who graciously agreed to partner with the Minnesota Center—individuals with exceptional patience and generosity of spirit. Over a four-year period of monthly meetings, the work group developed and presented three conferences for U.S. health care professionals—where the majority of speakers were Hmong—and organized several other educational activities, including the production of two videos of Hmong families’ bewildering experiences with Western health care. Early in the process, the work group planned a critical meeting with the Twin Cities’ clan elders to seek their advice about the work group’s proposed purpose and methods. Whether the efforts of the work group—consisting primarily of relatively young members of the Hmong community and U.S. health care ethicists—would be xii Healing by Heart embraced by the Hmong community elders was on the line. Most of the three-hour meeting was conducted in Hmong,but even to those who did not understand Hmong, the suffering recounted by people in their interaction with U.S. health care professionals was unmistakable and the emotion in the room was palpable. The clan elders indeed embraced the work group’s efforts and underscored the importance of helping health care professionals show respect and build trust with Hmong patients and families. Poignant stories were the common currency of the work group meetings and conferences . The power of the stories led to the collection and development of more than forty for use in various venues. It soon was evident that the insight that these cases provided into Hmong health beliefs, practices, and values, the delivery of culturally responsive health care, and tools to assist with identifying and addressing ethical issues in cross-cultural health care were not readily available in the literature. To respond to this lacuna, the Minnesota Center resolved to develop this book, Healing by Heart. As project director, Dorothy E. Vawter invited four colleagues to collaborate with her on this book. The editorial team represents the fields of family medicine, health care ethics, medical anthropology, nursing, theology, and social work and includes Kathleen A. Culhane-Pera, a family practice physician and medical anthropologist who has lived, worked, and conducted ethnographic research with the Hmong in SoutheastAsia and the United States; Phua Xiong,one of the first three Hmong women to become a physician in the United States, who has researched, educated, and provided health care to the Hmong communities in St. Paul, Minnesota, and Philadelphia , Pennsylvania; Barbara Babbitt, who has training in health care ethics and many years of experience in psychiatric nursing, cross-cultural communication, and community efforts to improve health care delivery to immigrant and refugee populations; and Mary M. Solberg, a professor of religion and a former social worker with crosscultural experience and editorial skills. The heart of this book is the stories and wisdom...