Why we won’t win in Iraq

January 9, 2007 in Hmong, Iraq, Missoula

by Jay Stevens 

I recently finished The Spirit Catches You and You Fall Down, an account of a community of Hmong refugees in central California. It’s a fantastic book and may deserve its own post — especially because Missoula also has a large community of Hmong — but I just want to talk about a chapter and how it relates to our failures in Iraq.

(The Hmong’s presence in Missoula is a fascinating story. A Bitterroot rancher and smoke jumper turned CIA liaison — Jerry Daniels — worked with our Hmong allies in Laos during our “engagements” in Southeast Asia. When the US pulled support for the Hmong after the collapse of Vietnam, Daniels was instrumental in evacuation of as many of the Hmong as possible, real heroic stuff, bought land in Missoula, and helped settle hundreds of refugees in the area.)

The central story of “The Spirit Catches You…” is the conflict a Hmong family has with Western medicine in treating an epileptic daughter. For the Hmong, many of Western medical practices violate traditional beliefs or morality:

…A txiv neeb [Hmong healer] might spend as much as eight hours in a sick person’s home; doctors forced their patients, no matter how weak they were, to come to the hospital, then might spend only twenty minutes at their bedsides. Txiv neebs were polite and never needed to ask questions; doctors asked many rude and intimate questions about patients’ lives, right down to their sexual and excretory habits…Txiv neebs never undressed their patients; doctors asked patients to take off all of their clothes, and sometimes dared to put their fingers inside women’s vaginas….

To add injury to insult, some of the doctors’ procedures actually seemed more likely to threaten their patients’ health than to restore it. Most Hmong believe that the body contains a finite amount of blood that it is unable to replenish, so repeated blood sampling, especially from small children, may be fatal….If the body is cut or disfigured, or if it loses any of its parts, it will remain in a condition of perpetual imbalance, and the damaged person not only will become frequently ill but may be physically incomplete during the next incarnation; so surgery is taboo…

Traditional Hmong medicine involves herbal remedies, ritualistic sacrifice, spirituality; basically a holistic approach, one where mind, body, and spirit are all treated together.

In 1985, Dwight Conquergood worked with an international relief agency in a Hmong refugee camp in Thailand to provide health programs for the residents. He described the Hmong people’s reaction to the Western-style camp hospital:

I heard horror story after horror story from the refugees about people who went to the hospital for treatment, but before being admitted had their spirit-strings cut from their wrists by a nurse because “the strings were unsanitary and carried germs.” Doctors confidently cut off neck-rings that held the life-souls of babies intact. Instead of working in co-operation with the shamans, they did everything to disconfirm them and undermine their authority….The refugees told me that only the very poorest people who had no relatives or resources whatsoever would subject themselves to the camp hospital treatment. To say that the camp hospital was underutilized would be an understatement.

Not only did the staff at the hospital ignore Hmong concerns, many of them were Christian missionaries looking to convert the refugees to Christianity, thus making a trip to the hospital a risk not only to the body, but to the soul, as well.

Basically Western disdain for Hmong tradition and beliefs drove them away from the obvious benefit that Western medicine could provide the refugees. To his credit, Conquergood used Hmong myth and storytelling techniques to convince refugees to use the hospital facilities, once arranging a “parade” of Hmong dressed in traditional costumes to convince people to bring their dogs to the hospital for rabies vacinations.

But Conquergood’s interaction with the Hmong wasn’t just about exploiting their own traditions to get them to use Western medicine. He was also the beneficiary of Hmong medicine:

During Conquergood’s five months in [the refugee camp], he himself was successfully treated with Hmong herbs for diarrhea and a gashed toe. When he contracted dengue fever (for which he also sought conventional medical treatment), txiv neeb informed him that his homesick soul had wandered back to Chicago, and two chickens were sacrificed to expedite its return.

Conquergood’s success, then, with the Hmong refugees was his ability to not only know them and their culture, but actually understand and appreciate it as well:

Conquergood considered his relationship with the Hmong to be a form of barter, “a productive and mutually invigorating dialog, with neither side dominating or winning out.” In his opinion, the physicians and nurses at [the refugee camp] failed to the co-operation of the camp inhabitants because they considered the relationship one-sided, with the Westerners holding all the knowledge. As long as they persisted in this view, Conquergood believed that what the medical establishment was offering would continue to be rejected, since the Hmong would view it not as a gift but as a form of coercion.

Have you ever read a paragraph anywhere that so magnificently sums up the reasons for our gross failures in Iraq? Does not the hubris and narrow-mindedness of the camp’s medical staff exactly mirror our own national rhetoric as we charged into Iraq?