Culture Shock A Review of Vietnamese Culture and Its Concepts of Health and Disease MAJ DUONG NGUYEN, MC, USA, Tacoma, Washington
Misunderstandings of Vietnamese culture and beliefs have led to many unfortunate incidents in the United States, including court cases for child abuse and even suicide. These can be avoided by an awareness of the cultural background of the Vietnamese, their philosophy oflife and the influence of religion and beliefs on their personalities, both as individual persons and as members of extended family units. The Vietnamese concepts of health and disease are presented, along with brief descriptions of certain folk medicines that are frequently misconstrued byAmerican physicians. (Nguyen D: Culture shock-A review of Vietnamese culture and its concepts of health and disease [Cross-cultural Medicine]. West J Med 1985 Mar; 142:409-412) April 1975 through February 1982, about 1.4 million Indochinese refugees fled their homelands. Nearly 580,000 (40%) of these refugees, most of whom were Vietnamese, have settled in the United States.t They have incurred, in turn, a host of cultural, economic, political, psychological and social upheavals.2 In contrast to the nearly 1 million Cuban refugees that have settled in the United States since January 1959, the Vietnamese refugees have had to confront more immediate problems: They had no previously settled ethnic group to offer initial support; their culture was more dissimilar to that of the Americans, and they have frequently been symbolically identified with the unpopular Vietnam war. In brief, their arrival in the United States marked the beginning of a long and arduous process of adjustment to a new life in a new country with an alien culture. Inevitably, misunderstandings have occurred. For example, a Vietnamese father took his 3-year-old son to an American hospital because of possible influenza.3 The child had many ecchymoses on his chest and back, and the father was suspected of child abuse. Although he explained that the ecchymoses represented cao gio-that is, a home treatment of coin rubbing-he was jailed and subsequently committed suicide. In the hope that such misunderstandings can be avoided, I will briefly review the cultural background of the Vietnamese; describe the Vietnamese both as individual persons and as members of extended family units; discuss Vietnamese religious beliefs and social heritage, and present the traditional Vietnamese health beliefs. om
The Oriental Heritage
"East is east and west is west. " The Oriental cultures and values differ considerably from those of Americans. For example, American civilization has thrived on overcoming and mastering nature, whereas the Indochinese cultures stress harmony with nature. Instead of towering skyscrapers, the ancient Asians constructed their houses not by height but to blend modestly with the environment, creating thereby a sense of tranquility with life. Even today, Indochinese persons aspire to have the trees, grasses, mountains and rivers provide warmth and protection for their houses, in the hope that nature will be supportive oftheir lives and their families.4 Moreover, the Oriental daily life-style is less stressful. People tend not to rush because their concept of time is much more elastic. In contrast to the almost compulsive punctuality of Americans, Oriental persons frequently arrive late for appointments. Vietnamese as Individuals Vietnamese have but a few family names for a population of 56 million persons (1982 figure), with Nguyen being the most common. Their names are always written in the following order: family, middle (sometimes twice) and first names. This order may create confusion for medical records keeping and is frequently a source of misunderstanding. Also, they are typically addressed by their first names (even by strangers), a practice that is occasionally denigrated by Americans. namese,
A person's age is also a source of...