Introduction

STORY THREE: Proud and Private
*This story is a composite.

Nao Kao Vang came to the United States after escaping from the secret war in Laos, spending time in a refugee camp in Thailand and making his way to Colorado via Hawaii and California. The secret war in Laos was a period of wide geographic dispersion that involved various tribes at war with each other and conflicting troops from the Soviet Union and U.S. military. Individuals from the same tribes often became separated – with villages of the same tribes supporting opposition sides because of the mass confusion and chaos of allegiances between friend and foe. When the elements of war arrived at the doorsteps of Vang’s family, there were few choices – to flee, suffer, die or resist. Nao Kao chose to escape with his wife, Lia, and his daughter, Bao, age 4, despite his connection to his tribe and village.

In the escape, the Vangs were separated from their two sons, Tou and Neng, ages 7 and 9, respectively. Through the turbulence and violence, Nao Kao had to maintain a strong spirit for himself and provide strength to his wife and daughter – all of whom were suffering privately from the loss of the boys and the grief of separation from their homeland, country, clan and larger extended families. When they arrived in the United States they did not speak English and struggled to be understood, not only linguistically, but within the context of their Hmong history, culture and traditions. During this period, in which they felt alone, alienated, isolated and misunderstood, Nao Kao began to suffer regularly with nausea.

Shortly after their arrival, their daughter began to have severe health problems. The Vangs took their daughter to the emergency room at a local hospital. Though the medical doctors worked tirelessly and were committed to identifying the source of Bao’s medical problems, their western approaches with a very different set of rigid rules felt uncompromising for the Vangs. The Vangs felt misunderstood by the medical staff that “lumped” them together with other Asian populations for simplicity or lack of cultural and historical understanding. Even with the help of their English-speaking family members, the Vangs struggled as they could not clearly describe the nuances of their daughter’s symptoms to the doctors in a way that could be helpful to diagnose their daughter’s medical problem. As a result of acute anxiety due to the apparent insurmountable cultural barriers for his daughter’s treatment, Nao Kao’s own health conditions worsened. He began to experience intermittent weakness in his arms and legs, yet he told no one so as not to detract from the main family problem at that time.

One afternoon, after months of miscommunication and multiple emergency room visits, the doctors prescribed a series of complicated prescriptions that were foreign to the Vangs and difficult to understand and administer properly. Nao Kao had difficulty reconciling whether to accept the American treatment methodology or continue to treat his daughter in a way that was consistent with the Hmong traditions. But he wanted to make the best decision for his daughter. As he struggled to find the answers that were appropriate for him and his family, he withdrew from his community to keep his issues private, began to suffer from chest pains and finally realized that he needed to get help.

After his difficult experiences with the western medicine, Nao Kao chose to go to a traditional healer within the Hmong community. As the traditional healer was familiar with the historical context and cultural issues that Nao Kao faced, he quickly recognized his physical problems as being somatic due to severe depression and anxiety tied to the trauma resulting from the loss of his boys, the stresses of immigration and now complicated by his daughter’s illness. The traditional healer worked with Nao Kao to undergo first a series of healing ceremonies and moxibustion, which resulted in the alleviation of many of his symptoms. Later, the traditional healer worked together with Nao Kao, his wife and daughter, holistically, as a family unit, and within the context of their culture and historical experiences to help complement the treatment needs of the whole family. By approaching services in this manner, the healer helped to reconcile the family issues of loss, pride and shame with the greater community. The healer also served as a broker for bridging traditional Hmong and western medical establishment and created a series of treatments that combined the U.S. prescriptions with culturally-appropriate remedies and practices.