Understanding cultural differences is a very important aspect of delivering health care to various populations who have immigrated to the United States from various parts of the world. Collaborating with others to explore these differences allows you to gather varying viewpoints on these differences and how they might impact health care delivery.  Part I: Individual work Select 1 chapter in The Spirit Catches You and You Fall Down that discusses Hmong history (Ch. 8 to 14) to read individually. Write a 350-word summary of the chapter that includes the following: · Identify the historical events or cultural practices in your selected chapter. · Examine and describe how these differences create disparities between U.S. health care and the Hmong in California. Share your summary with your team. Part IA: Teamwork Discuss as a team the key historical events or cultural practices you each found in your reading and summary. As a team, identify commonalities of Hmong history and cultural practices that recur throughout the chapters. Create a list of 3 to 5 key cultural practices or factors that could impact health care program delivery to the Hmong community. Include a 2- to 3-sentence description to support your choices .(All you need to do is come up with 1 key cultural with a 2-3 sentence description for this part) Part B: Individual Reflection: Write a 350-word summary explaining how the 3- to 5-key factors your team identified apply to the chapter you read. Describe how these factors impact the differences in disparities between U.S. health care and the Hmong in California. Cite 3 reputable references to support your assignment (e.g., trade or industry publications, government or agency websites, scholarly works, or other sources of similar quality). PART2::: DISCUSSION QUESTION Visit the Child Welfare Information Gateway. · What are the primary responsibilities of the health care industry in preventing child abuse and neglect, responding to child abuse and neglect, and supporting and preserving families? · What circumstances should be present (or what considerations should be made) before removing a child from the guardianship of the parent? Include sources/references to support your perspective. Classmate1:   Summary  There were many historical events and cultural practices in the Hmong culture. First of all it was so hard to appropriately treat Lia's epilepsy due to unfortunate circumstances. The family had their cultural beliefs and secondly there was a language barrier that stood in the way, that did not allow them to fully understand the diagnosis, and the severity if not treated. They believed that the seizures she was having made her special. They believed in traditional healing per their cultural beliefs, and this was was to call back her soul. They believed that tradi.

1. Understanding cultural differences is a very important aspect of
delivering health care to various populations who have
immigrated to the United States from various parts of the world.
Collaborating with others to explore these differences allows
you to gather varying viewpoints on these differences and how
they might impact health care delivery.
Part I: Individual work
Select 1 chapter in The Spirit Catches You and You Fall Down
that discusses Hmong history (Ch. 8 to 14) to read individually.
Write a 350-word summary of the chapter that includes the
following:
·
Identify the historical events or cultural practices in
your selected chapter.
·
Examine and describe how these differences create
disparities between U.S. health care and the Hmong in
California.
Share your summary with your team.
Part IA: Teamwork
Discuss as a team the key historical events or cultural practices
you each found in your reading and summary.

2. As a team,
identify commonalities of Hmong history and cultural
practices that recur throughout the chapters.
Create a list of 3 to 5 key cultural practices or factors that could
impact health care program delivery to the Hmong community.
Include a 2- to 3-sentence description to support your choices
.(All you need to do is come up with 1 key cultural with
a 2-3 sentence description for this part)
Part B: Individual Reflection:
Write a 350-word summary explaining how the 3- to 5-key
factors your team identified apply to the chapter you read.
Describe how these factors impact the differences in disparities
between U.S. health care and the Hmong in California.
Cite 3 reputable references to support your assignment (e.g.,
trade or industry publications, government or agency websites,
scholarly works, or other sources of similar quality).
PART2::: DISCUSSION QUESTION
Visit the
Child Welfare Information Gateway.
· What are the primary responsibilities of the health care
industry in preventing child abuse and neglect, responding to
child abuse and neglect, and supporting and preserving
families?
· What circumstances should be present (or what considerations

3. should be made) before removing a child from the guardianship
of the parent?
Include sources/references to support your perspective.
Classmate1:
Summary There were many historical events and cultural
practices in the Hmong culture. First of all it was so hard to
appropriately treat Lia's epilepsy due to unfortunate
circumstances. The family had their cultural beliefs and
secondly there was a language barrier that stood in the way, that
did not allow them to fully understand the diagnosis, and the
severity if not treated. They believed that the seizures she was
having made her special. They believed in traditional healing
per their cultural beliefs, and this was was to call back her soul.
They believed that traditional medicine would put limitations on
the spiritual healing. They had no idea that this was a
neurological disorder, she possible was born with this and had
not realized or evolved as she got older. Epilepsy is not caused
by someone hearing a noise at the door. They believed that this
noise caused her spirt to leave. The child had to go through
what she had to due to strong cultural beliefs. The differences
between U.S. health and Hmong in California is; spiritual
healing and traditions that the spirits affect human lives, their
traditional ways are super important, they great respect for the
elders, this is why the younger generation does not try to
impose traditional medicine as in the U.S. The U.S. would have
treated her as the primary care physicians suggested. Due to
ongoing seizures untreated the brain was affected, and she
became mentally retarded. The social workers reunited her with
her family, but the damage was done. She also suffered trauma
from being separated from her family, as the primary care
physician thought this was best as it was a form of neglect on
the families part. When the decision to administer the
medication was finally made, her condition worsened and she

4. had a grand mall seizure which is the worst, and then her body
went into septic shock. She came home and lived for 26 years,
they still traditionally had ceremonies to ease her suffering and
believed that it worked. Very strong tradition, beliefs and
cultural background. It speaks for itself, and they fought hard to
maintain their culture. They stuck together and stood ground for
what they believed in, they did not surrender or submit to
traditional medicine and doctors ways. They thought that the
body had minimal amount of blood, and that taking ones blood
could be harmful and or fatal, surgeries to lead to disfiguration
and that if an autopsy was to be preformed after death, that the
persons soul would never become reborn again. They stood firm
on their beliefs, and really did not care to hear what the
consequences or outcomes may bring.
Part II Teamwork (Response)
Some historical events that were noted in reading these chapters
were the ceremonies for the calling back of her soul, sacrificing
of the animals. In the Hmong history and cultural they believe
that your soul remains in the gravesite for 13 days. They pray
and sing during this time , they don't believe in having surgery,
they communicate with the spirits on a continuous basis. They
believe in life after death, a shaman is the person who is called
to communicate with the spirits. they believe that a Shaman can
cure a sick person, they have some minimal shamans, and have
others who can preform more strongly.
List of Key Cultural Practices (Response)
Would be to maintain relationships with their relatives. They
have ultimate respect for their relatives and family members.
They remember their sufferings, they want to live life and be
free! I would say most importantly to the Hmong culture would
be; family, cultural and spiritual traditions and rituals to go on
for generations. They will preserve these cultural practices, by
starting at a young age and it will come naturally.
Part III Individual Reflection:
My team identified several factors, the spirits, and the
significance of cultural meaning and rituals. We all touched on

5. how strong the beliefs were that the culture was so strong, that
the family was in denial that she was truly ill. These differences
and beliefs are very different from from the U.S. traditional
ways, some of these ways could be harmful but when it comes
to dealing with cultural beliefs, all we can do is inform them,
we are not able to force anyone to do anything. The language
barrier was another added extra big problem, In the US this can
also be compared to natural health care, some people choose not
to take medications, for certain beliefs, they tend to go with a
natural supplement approach, or herbal treatments. This would
also be known as integrative medicine. My opinion is its fine to
have strong beliefs and cultural differences. and try so hard to
stay with what you believe in and were raised to do. When it
comes to a point where you or your family member is that sick
and needs help, one may have to set those aside as a special
circumstance, I am sure it will be very difficult. Our culture is
very different her in America, we believe in medicine, and if we
are sick we automatically get treated. We have different
cultures her in America, and we do have some very strict
religious, and cultural families that just don't get the
recommend treatment for themselves nor their children.
References:
Swihart DL, Yarrarapu SNS, Martin RL. Cultural Religious
Competence In Clinical Practice. [Updated 2021 Dec 2]. In:
StatPearls [Internet]. Treasure Island (FL): StatPearls
Publishing; 2022 Jan-. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK493216/
Institute of Medicine (US) Committee on Health Literacy;
Nielsen-Bohlman L, Panzer AM, Kindig DA, editors. Health
Literacy: A Prescription to End Confusion. Washington (DC):
National Academies Press (US); 2004. 4, Culture and
Society. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK216037/
Ahn, L. H., Kivlighan, D. M., Jr., & Hill, C. E. (2022). Helping

6. skills courses: The effects of student diversity and numeric
marginalization on counseling self-efficacy, counseling self-
stigma, and mental health. Journal of Counseling Psychology,
69(1), 27–36.
https://doi.org/10.1037/cou0000573
Classmate2:
I have read chapter 9 " a little medicine and a little Beeb" in the
chapter they discuss the sacrificing of animals for gran events.
The family had sacrificed a cow for her return back home from
foster care. They invited the whole family to celebrate the
return of their daughter, in California they had passed a law
which forbid the sacrificing of animals. This did not last very
long they is many cultures in California who believe in Santeria
and much sacrificing of animals is done. In my Hispanic family
we have slaughtered animals before for a big family celebration.
My dad for many years would make a pig for our birthdays, the
delicious food we would eat that day. As the Lee's used the
whole cow and had a gran feast my family did the same with the
pig the book mentions gathering family is difficult but offering
food has always brought family together.
The Lee's still had used money Leah was receiving from social
security to buy the cow, it was purchased from a local farmer
and was chopped up into small pieces to be able to fit into the
floor of the car. The Lee's placed the whole head of the cow in
front of the house to welcome Leahs's soul. In California the
Hmong community was known for the sacrificing of animals and
there was no problem one incident led to a house fire where a
firefighter opened the fridge and saw a pig but spread lies that it
was a cat. The rumor grew of hiding your pets or they would be
eaten that is why the community had no overpopulation inf
strays. In the chapter it discusses how Leah gained much weight
due to the parents giving anything she wanted, even though
being given a schedule the seizures had lessened but the Lee's
still did not want to follow the doctors' orders when it came to
Leah's daily activities.

7. Classmate3:
The chapter I read and will summarize was Chapter 13 - Code
X. This was a hard one to read as most of the other chapters in
this book- but its really telling of the undying love of the family
.
Some of the historical events that were described in this chapter
was the account of the Lee’s recollection of being in a war and
loosing three children in the span of three years. The realty that
they faced with possibly loosing a child in this manner in such a
sophisticated place such as the Children's Hospital in Fresno ,
Ca was more tragic and emotional than having to leave Laos
after the war .. where as the Lee’s said they dodged bullets, land
mines and even walls of fire. Also for context, Lia has been in
and out of the hospital, she has been n foster care and now she
is back in the hospital in a comatose state. Non responsive and
essentially in a vegetation state.
The pain of watching their child die in front of them was
unbearable, and they would not follow any medical orders that
were given by the hospital. For example, it was New Years and
the family wanted Lia to dress up for New Years Eve- and the
staff (nurses and Drs) said she should not put on a jacket as
they will need access to her upper body. The family did not
comply and dressed up Lia.
After this, the parents had it their mind they wanted to take her
out of the hospital, even though the orders were being set up,
and instructions were given to the family without an interpreter,
the father would not wait a few more hours. He took her off her
tracheal tube picked up her almost lifeless body and ran down
the stairs with Lia in his arms. This is when the hospital
alarmed a CODE X .. meaning there was a security breach. The
Lee’s did eventually took her home, and when Lia left the
hospital her temperature was 104 and when the Lee’s bought her
home they washed her, and instead of dying like the drs and

8. nurses told her she would, she thrived at home, and she made a
gradual improvement.
In the Hmong culture, you are not to give sick people
medications, the instructions for the care at home were to give
her medications- the mother, Foua, had no intentions on ever
giving her any medications.