Rebeca Guzman is providing outreach and educating health care workers about the Hmong culture.

Many cultural conflicts exist between Eastern philosophies and American medical practices. This is particularly true for the Hmong community, a southeast Asian population that has settled in Detroit after migrating primarily from Laos, Thailand and Vietnam. With language barriers and lack of resources, the Hmong people have had a difficult time getting adequate access to health care.

Rebeca Guzman, a social worker and Wayne State University research assistant, is helping to break down cultural barriers. “The Hmong people are a patriarchal, clan-structured community, so they are somewhat closed off from outsiders. But they do need help getting medical treatment within the context of their value system,” said Guzman.

Through the department of community medicine, Guzman obtained several grants to improve health care for Hmong people over the course of several years. The first step was to train several bilingual people from within the Hmong community to serve as trusted liaisons to outside resources.

With support from the WSU Institute of Maternal and Child Health, Guzman also developed an informational brochure that Hmong women could give their physicians to make them aware of important cultural concerns. For instance, most women are given ice chips or ice water during childbirth, however Hmong women believe that lowering the body temperature slows healing and makes them susceptible to illness. In addition, Hmong women are very uncomfortable in the presence of male doctors, and unnecessary touching or personal contact is regarded as rude or disrespectful. This is in sharp contrast to many Western women who may prefer massage therapy and value a more personal relationship with their physicians.

“Few American practitioners ask patients from other parts of the world about their preferred health care practices and beliefs,” said Guzman. “We hope these materials will accomplish two important goals: to advocate for Hmong patients, and to educate physicians and health care workers about other cultures.”

Related Hmong projects directed by Wayne State University included: a directory of Hmong-friendly businesses, a bilingual community resource guide, cultural diversity training for local police officers, coordination of a quarterly Hmong newsletter, and production of a training video for service providers about prevention of substance abuse, which is becoming more common with Hmong youth.

“Overall, we want to open the lines of communication and service to this group of citizens,” said Guzman. “And we want physicians to recognize how important it is for them to remain in touch with the communities they serve.”