“You have to have children to be happy:” Exploring Beliefs About Reproduction with Burmese Refugee Women in the United States

http://scholarcommons.usf.edu/etd/4154/

            During my lit review quest for sources, I came across this paper and automatically made the connection to an interview that I had the opportunity to sit in on that was conducted by KQED reporter, Shuka Kalantari, to physicians and navigators at Asian Health Service (same AHS mentioned in my previous post) in Oakland. This paper emphasizes how work done by scholars needs to be done in order to help service providers and communities share their needs with each other. With more collaboration, solutions to the many issues refugees face can be found. Today, there is little know about the various Burmese ethnic groups.

            However, in this blog post, I would like to talk about some of the topics that these interviews highlighted to me. I had read a lot about high rates of asthma in children and poor exposure to sex education in adults, but with all of these studies floating around, it was difficult for me to actually pinpoint what were the major concerns for Burmese refugees coming to America. Through listening in on this interview, I realized that through conversation and actual examples, my understanding of the major issues that these refugees face was sharpened.

            For the men, everyone talked about how almost all of the Burmese men they treated suffered from alcoholism. They believe that alcohol serves as a crutch to relieve these men from their anxieties of unemployed, living in unstable housing, and history of involvement in the army (many are anti-government). However, alcoholism is a problem in screening for Hep B and C, because testing for both cannot be monitored when alcohol is in the system.

            Women that were seen at AHS, typically about 50 years of age often classified themselves as “culturally old” and possessed a strong sense of being useless. When they were young, they had more tangible problems, because they actually lacked food on the table, but now their problems have progressed to worries about what will happen when their children move out and they lose their role as caregiver. Instead of taking care of the whole family, now, these women only needed to focus on themselves. Health Navigator, Kwee Say, says that many become hopeless that they can achieve much because of their low level of education, age and language barriers.

            Doctors also highlighted the difference between the refugees they treated and other patients. They said that many had chronic pain that could not be pinpointed, which was different, because much of the American-born population had pain that peaked at a high intensity, and then weaned. Also, the doctors all brought up how the refugee’s needs are not easy to fulfill. They talked about the different classifications of refugees they saw in the Bay Area. Those who came earlier in 1960s were typically educated and individualistic. Many were rebels/freedom fighters and required less assistance in terms of ESL classes. However, refugees from Malaysia were typically economic migrants and illiterate. The refugees that organizations like IRC work with today are from remote villages. Often, these individuals are from areas that lack a solid education system, so many are also illiterate and have to face major adjustments of them when they come (including the way they go about dealing with health conditions). Back in their villages, if they needed medicine for some illness, major or minor, they could go to a roadside stand and ask for anything the wanted and get a hold of it for low costs. However, in America, the insurance systems and prescription process is very confusing for many refugees. Thus, many do not refill their medicine on their own, but come back to their doctor, confused about the process.

            Many will come with the “American Dream” in mind, but are often faced with struggles as they assimilate into a place that is so different than their expectations of America. One of these factors that the staff at AHS brought up was the culture clash they face in the Bay Area. With a new exposure to ethnic diversity and English, relating to others is a struggle for many refugees. Even in English classes, they are discouraged as instructors, who are often volunteers, who do not know the refugee’s native tongue, teach classes. Thus, when they struggle to learn, clients lose their hope and feel incompetent. MD, Suzie Lim brought up one patient’s complaint about the different perspective on treating public space. Previously, they felt like the whole land in their village was theirs, as there were shared boundaries. However, in America, they feel a loss of freedom as they cannot roam the land as freely as before.

            With these many fragmented examples, I have been learning the importance of each individual’s story. As we have learned about survey methods and means of collecting accurate data, I can see how large-scale programs and projects require solid quantitative data for funding, but my experience at IRC has revealed to me the importance in personal interaction and the stories of each individual. As many of you are going off to your practice experiences, I would encourage you to think broadly about how you go about understanding the needs of the people. It is in each story that we, as outsiders, can come to know pieces to hopefully one day, fully understand the people we are working alongside.