Cultural Awareness Project-Vietnam
By: Sritej V. and Vidhath V.
Rice is the dietary staple which most people eat three meals a day. Rice is usually consumed jointly by family members. The common practice is to prepare several dishes that are placed on a tray or table that people sit around. Individuals have small bowls filled with rice, and then take food from the trays as well as rice from their bowls with chopsticks. Vietnamese often accompany these main dishes with leafy vegetables and small bowls of salty sauces in which they dip their food. Popular dishes include sautéed vegetables, tofu, a seafood-based broth with vegetables called canh, and a variety of pork, fish, or meat dishes. A common ingredient for cooked dishes and the dipping sauces is salty fish sauce (nuoc mam). Another important family practice is the serving of tea from a small tea pot with small cups to guests. Northern cuisine is known for its subtle flavors, central cuisine for its spiciness, and southern cuisine for its use of sugar and bean sprouts. Diet varies with wealth; the poor often have limited amounts of protein in their diets and some only have the means to eat rice with a few leafy vegetables at every meal.
Religion plays a role in the perception of, interpretation of, and behavior
toward health and illness. Prevention – Health is a state of physical and spiritual
harmony with nature; balance of the two forces yin (cold) and yang (hot).
1) Cold remedies if yang is overpowering and hot remedies if yin is overpowering
2) Herbal remedies
3) Acupuncture and acupressure
4) Energy to restore balance between yin and yang
Male and Female Roles
In Vietnam, tasks were divided along gender lines: fathers typically worked outside the home while mothers were responsible for domestic duties such as homemaking and raising children. Vietnamese culture is based on a patriarchal system, meaning the husband acts as the head of the family. His responsibilities include managing money and supporting the family.
The male dominancy trait is also apparent socially among older generations of Vietnamese. Men will answer questions for their wives. For example, if someone asks his wife, “How are you today?” the husband might respond, “She’s OK”.
However, the gender gap between men and women became closer during the Vietnam War, when many men were absent from the home and women took on more independence out of necessity. This trend has continued with migration to the U.S. Many of the jobs available in the U.S. were of lower status and fit the expectations of refugee women, but not of refugee men. Refugee men have been forced to take lower status jobs than they would have taken in Vietnam. This has created a situation where many families are dependent on the income of the mother, causing readjustment of family roles and expectations. Due to the effect of migration and Western influence, traditional gender roles are changing, and Seattle families display varying degrees of traditionalism. In general, Vietnamese men and women working outside the home in the Seattle area share domestic duties.
Previously men had more education than women. The gap is closing, and now everyone has an equal opportunity to receive an education, especially in the U.S. This higher educational attainment means that more women are now working outside of the home.
Women who have emigrated from Vietnam tend to extend the absence from work after giving birth in order to raise children. It is likely that they will remain at home until the children are ready to start school. But if both parents were raised in the U.S. it is more likely that they will place their children in childcare so both parents are able to work.
The diagnosis of illness is frequently understood in three different, although overlapping, models. They believe illness can come from spiritual causes, imbalance of the yin and yang.
Traditional techniques of healing include:
- Coining - A coin dipped in mentholated oil is vigorously rubbed across the skin in a prescribed manner, causing a mild dermabrasion. This practice is believed to restore balance.
- Cupping - A series of small, heated glasses are placed on the skin, forming a suction that leaves a red circular mark, drawing out the bad force.
- Pinching - Similar to coining and cupping, the dermabrasion is formed by pinching the skin, which allows the causative force to leave the body.
- Steaming - A mixture of medicinal herbs is boiled, the steam is inhaled, and the body bathed.
- Balm - Various medicated oils or balms are rubbed over the skin.
- Acupuncture - Specialized practitioners insert thin steel needles into specific locations known as vital-energy points. Each of these points has specific therapeutic effects on the corresponding organs.
- Acupressure or Massage - Fingers are pressed at the same points as with acupuncture, and together with massage, stimulate these points to maximize their therapeutic effects.
- Herbs - Various medicinal herbs are boiled in water in specific proportions or mixed with "wine" and consumed to restore balance.
- Patent Medicines - Powdered medicines that are mixed or boiled with water and taken for certain ailments.
General Statement for the Healthcare Provider
Vietnamese view American healthcare as a way to relieve symptoms. They expect to be prescribed something to cure their illness immediately. Vietnamese frequently discontinue medicines after their symptoms disappear because they feel that if they don't experience any symptoms, there is no illness. Therefore, preventive, long-term medications must be discussed in length using culturally pertinent education. It is quite common for Vietnamese patients to save large quantities of half-used prescription drugs so taking the full course of antibiotics must be discussed in length.Ê Western medicines, especially oral medications, are seen to throw the body out of balance.This could be seen as another barrier to compliance. In this case, alternatives like a balm may better meet the patient's need while still considering their cultural values. Vietnamese commonly believe that Western pharmaceuticals are developed for Americans and Europeans. They believe that the dosages are too strong for their cultures body build so they might readjust their dosage to what they consider to be correct.
Vietnamese hold great respect for those with education, especially doctors. The doctor is considered the expert on health. They expect doctors to diagnose and treat all in one visit with little examination or invasive laboratory or other diagnostic tests. In addition, laboratory procedures involving the drawing of blood are feared and even resisted by Vietnamese, who believe that blood loss will exacerbate their illness and that their body cannot replace what was lost. Surgery is particularly feared for this reason and is used only as a last resort.
It is common for Vietnamese women in the U.S. to seek conventional prenatal care when pregnant.
Both in Vietnam and the U.S. it is considered shameful and dishonorable to the family if an unmarried woman is pregnant. Therefore, women who are pregnant outside of marriage may try to keep the pregnancy secret from family members for as long as possible.
Chinese culture has strongly impacted Vietnamese medical beliefs. The balance of the equal and opposite forces of yin and yang can provide explanations for illness. Yin is the female principle and is associated with cold, the breath, the right side and even numbers while yang is the male principle and is associated with heat, the blood, the left side, and odd numbers. The harmony of these forces can be affected by different foods and behaviors. Yin and yang are very important and are believed to be able to affect the pregnant women and her child (Bodo & Gibson, 1999).
In Vietnam, particularly in rural areas, prenatal care is lacking, but there are many traditional practices that women follow to ensure an easy pregnancy and a healthy baby. Overeating is discouraged because it can make the delivery complicated. There are certain foods that will disturb the woman’s yin/yang balance including “hot” foods such as alcohol, coffee, unripe fruit, red meat, spicy soups, garlic, ginger and red pepper or “cold” foods such as ice cream, ice water, bananas, oranges, and gelatins. Foods that are acceptable include poultry, fish, pork, ripe fruits and vegetables, rice, chicken eggs and ginseng. Physical activity is encouraged throughout the pregnancy, while reclining for long periods is discouraged to prevent the fetus from growing too large. Sexual relations are believed to lead to respiratory illness or mental and physical deformation of the child (Bodo & Gibson, 1999).
Traditionally in Vietnam, husbands are not present during delivery. Only the nurse or doctor is in attendance. The husband and male relatives are required to wait outside until the baby is born. The system in the U.S. encourages men to be present during the birthing process. Therefore, it is common for the father to be present at the delivery.
The baby’s first cry proves it has a soul and is therefore a moment of celebration (Bodo & Gibson, 1999).
In rural Vietnam, midwives or women experienced with assisting in child birth deliver babies. But if a hospital is accessible it will generally be used.
Death is one of life's unique experiences. A person's attitude towards death and bereavement is shaped to a large extent, by their cultural heritage, religious practices and family unit.
In Vietnamese culture, religion dictates some of the rituals in the dying and bereavement process.
In Buddhism for older people who are ill and know they are going to die, death is acceptable and is not shocking to the family. If a dying person is Buddhist and is in the hospital , he or she will ask for the monk to come to the bedside and ask them to chant. If the monk is not available, you could bring some elderly people who can do the chanting.
In case of death, It is very important to contact the family and ask them what they would like to do, before officials come. Some people believe that within the body the brain may die but the heart is still working. This makes the last minutes of life a very important time for the person to settle, to get ready for rebirth.
A person usually prefers to pass away at home with the family members around them. If the person has to die in the hospital they may wish to be around their family members. If a person does not die at home, it is regarded as causing bad luck for the family.
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