The Hmong are agrarian people who emigrated from China to the mountainous regions of Northern Laos following centuries of persecution. They are an indubitably independent people, geographically and culturally separate from the rest of Laos, but they have a long history of standing alone to fight for their adopted homeland. Their 4,000-year-old culture treasures concepts of honour, commitment, loyalty, and freedom; in fact, the word ‘Hmong’ is said to connote ‘free people’ or ‘those who must have their freedom and independence’. A group of women were among the first of the Hmong people to be trained in Western healthcare in order to work as nurses on the frontlines of the Secret War in Laos. In such positions, they were encountering Western medical and healthcare practices for the first time. Within the Hmong culture, healing is the province of the shaman, whose practices align with their animist spiritual beliefs rather than medicine’s presumed superior knowledge of the physical body. In animism there is no perceived separation of body and spirit – these believers adopt a holistic approach to illness and injury that requires treating the spirit in order to allow for the body to heal. In the words of Anne Fadiman, ‘Hmong preoccupation with medical issues [is] nothing less than a preoccupation with life (and death, and life after death)’. In this respect, the traditions of the Hmong would continue unchanged long after the war in Laos ended, but the ministrations of the Hmong nurses during the conflict would become a welcome additional source of healing for their people.
Amid the chaos of physical destruction, displacement, and death that repeatedly characterised war-torn Northern Laos for nearly three decades – from WWII through the Secret War – a handful of Hmong youth were selected to participate in a highly demanding training programme to become the first-ever Hmong nurses educated in Western healthcare methods by volunteer American nurses. Most of these recruits were young women – really no more than girls – who left their families, villages, and local culture behind to travel to unfamiliar places that seemed to promise adventure and opportunity beyond what they could count on at home. They were uniquely willing to seek out additional education and, in some cases, openly defy their families; they welcomed the opportunity to explore new roles for women. As nurse Yia Lee states, ‘I saw how hard my mother worked in the fields and the rice paddies. I thought to myself that I would not farm in the rice field. I told my mother this and I promised her.’ These individuals were both pioneers in a new, more modern way of life for Hmong women and mavericks in the eyes of their community, which expected girls of thirteen to sixteen years of age to marry, raise children, and work in the fields. Given the near complete transfer of able-bodied males from the villages to the frontlines of war, women were vital to sustaining the cultivation of crops for food. Indeed, even while the communists were successfully kept out of the fertile plains of Northern Laos, communities struggled to survive amid the increasingly precarious political and physical circumstances resulting from the escalating conflict.
One nurse, Choua Thao was born into a Hmong village family in Northern Laos. She became an accomplished nurse, eventually fleeing to the refugee camps in Thailand, after the Communist takeover of Laos, where she worked more in the role of a physician because there was little to no health services available. She immigrated to the United States in 1976. Now settled in Minnesota, the following narrative is excerpted from the translation of her initial interview on 30 June 2010.
I was sent off to nursing training with another Hmong girl; we were the first ones recruited to the programme in Xieng Khoung. I was fourteen then. . . . Once my studies were done, I would do hands-on work at the clinic nearby; the programme was for one year. When I was able to give shots to people, I was sent to Vientiane to study for another six months to get practical nurse training. . . . In 1961, Dr. Westermeyer offered to send me to Thailand and America to continue my studies. I did not go to America because I was already married with three children and my husband did not agree; I went to Thailand instead. After that, Pop Buell put me in charge of the hospital at Sam Thong because there was no one else to do it. . . . I taught nearly all the Hmong nurses . . . [and] I did everything exactly like the American nurse . . . The curriculum for nursing training consisted of the following: first, learning to take a pulse and temperature, while learning anatomy and physiology and how to wrap up wounds. After three months, students would learn how to administer shots and set-up IVs. Next recruits would learn more about specialised medicine – for instance, gynecology. . . . The hospital had about 400-500 patients, and most were soldiers. . . . There were many terrible incidents, but I was not afraid. Not even when a doctor, trying to save a young boy’s life, cut into the boy’s chest and grabbed his heart, pumping it [with his hands]. I remember exclaiming, ‘are you crazy?!’ to the doctor, who merely replied that he was trying to see if he could make the boy live. Many boys died, and I assisted with many autopsies as well; I was proud I could assist. Sometimes I did autopsies alone. Before I do any autopsies, though, I would talk to the deceased person to ask her or his spirit for approval to invade their body by saying, ‘Oh _____, I have to cut you open to find out why you have illness and now that we’re done I am closing you up so you can reincarnate and I wish you never have this illness again’.
This is taken from the article ‘Expanding Boundaries: Hmong Nurses in Laos during America’s Secret War, 1954-1974’ by Dian L. Baker, May Ying Ly, and Colleen Marie Pauza. If you want to read more, it appears in the Spring 2011 edition of the Women’s History Magazine.