The Montagnard Population of North Carolina

The Montagnard Population of North CarolinaAimee LoveAnderson WilliamsonMichelle Petty

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Who are the Montagnards?Natives of the Central Highlands of Vietnam and CambodiaMontagnard means mountain peopleAlso referred to as DegarIndependent from the mainstream Vietnamese population

Figure 1. Finney, R. (2015). Reference 3, 4, 8 & 9

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Who are the Montagnards?Over 30 languagesMost common in NC: Rhade, Jerai, Koho, MnongReligionAnimism was common religion until settlement in NCChristianity is most common religion in NCThe church is a major outlet for social supportEducation:Men: generally have only up to a primary school education levelWomen: no formal educationReference 3, 4 & 8

Who are the Montagnards?Housing:Traditionally lived in villages of longhousesContinue this tradition by sharing housing and resources in NCFamily:MatrilinealTraditionally the men work outside the home while the women take care of the home, children, and financesNC Immigrants are more likely to share these roles

Reference 3, 4 &8

Where are the Montagnards Settled?The Montagnards sought refuge within the USSpecifically in North Carolina due to the large special forces presence in the areaPopulation of 5000 Montagnards in North CarolinaMajority in GreensboroAlso large populations in Charlotte, Raleigh, and New Bern

Montagnard Dega Association of Greensboro FlagReference 3, 4 & 8

The Montagnards: Settlement in North CarolinaHistory of tension with mainstream Vietnamese populationThe Montagnards came into contact with Americans during the Vietnam War as the Ho Chi Minh Trail was located within their settlementFought with Americans during the Vietnam WarFront-line fighters trained by the US Special ForcesFostered a relationship between the Americans and MontagnardsAfter the Vietnam WarMontagnards faced backlash due to involvement with US MilitaryReference 3, 4 & 8

The Montagnards: Settlement in North Carolina3 Major immigrations:1986: 200 people Mostly men1992: 400 people269 men, 24 women, 80 children2002: 900 peopleMostly menOthers have immigrated throughout the years via family reunification, the Orderly Departure Program and other services

Reference 3, 4 & 8

Montagnards: Beliefs Regarding DietIn Vietnam Historically they lived healthy lives living off the landAfter the Vietnam war they lost much of their farming land and subsequently there was a decline in their nutritional health In the United StatesDue to a shortage of women in the home and a lower income status, the traditional healthy diet has sufferedYouth have adapted quickly to American fast foodReference 3, 4, & 8

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Montagnards: Beliefs Regarding Mental Health They do not subscribe to Western ideas in regards to mental healthMental health is viewed as a spiritual problemSevere behavioral disorders are generally tolerated within the communityIf behavior appears too disrupted or dangerous they may be out casted from the community Reference 3

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Montagnards: Beliefs on Disease Treatment and PreventionPreventionDo not traditionally think about disease preventionDo not seek medical care except in emergenciesTreatmentReceptive to treatment and health educationReference 3

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Montagnards: Health ConcernsIn VietnamWar related injuriesMalariaTBPTSDCancerPoor nutritionIn the United StatesDiabetesHypertensionPTSDAlcoholismDomestic ViolencePoor nutritionReference 3, 4, & 8

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Montagnard Challenges Related to Health Care in the United StatesLack of health insurance due to jobs with inadequate health insurance, limited income, and ineligibility for Medicaid due to refugee statusLanguage barrier there are over 10 dialects within Montagnard community, many health care places do not offer translation and are unaware of their language skillsLack of education to disease, prevention, and treatmentReference 4 & 3

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Montagnards: Resettlement IssuesCommunity complaints about Montagnards hunting and slaughtering animals in food preparationSocial Services involvement due to the use of physical punishment within the familyProblems secondary to alcohol abuseDriving violations secondary to the lack of knowledge to driving rules (DUI, lack of insurance, expired license, tags, registration and inspection stickers)Lack of awareness to mainstream culture (leaving upholstered furniture in ones yard)Reference 3

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Montagnards vs Vietnamese Montagnards do not consider themselves VietnameseMany Montagnards do not speak VietnameseMontagnards consider their homeland separate from VietnamThere is a long history of tension between Montagnards and the mainstream VietnameseMontagnards have been punished by the Vietnamese post war due to their allegiance with the United StatesMontagnards maintain a lower social status than the Vietnamese

Reference 3 & 8

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Montagnards vs Vietnamese - SimilaritiesLack of disease prevention practicesHigh rates of PTSD, cancer, mental disorders, infectious disease, TB & Malaria Do not believe in psychiatric careStrong family bondsLanguage barriersReceptive to treatmentReference 3, 7, & 8

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Montagnards vs Vietnamese - DifferencesMontagnards10 thousand live in the United StatesLargest population in North CarolinaMajor religion - Animism, Christianity, and CatholicismDo not speak Vietnamese

Vietnamese 1.2 million live in the United StatesLargest population in CaliforniaMajor religion Buddhism, Confucianism, and TaoismSpeak Vietnamese

Reference 3, 7, & 8

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How Do These Beliefs Impact ANP Approach to CareLanguage and Cultural barriersChronic illness (diabetes and High Blood Pressure)Mental illness (ETOH abuse)EducationDietHard to reach familiesKeeping follow-up doctors appointmentsFollowing treatment plansPoverty- unable to pay medical bills

Reference 1 & 8

Interventions for this populationImplement a community health centerProvide free screening for diabetes and high blood pressureIdentify and recruit translators from the communityIncorporate Community Health Workers, (CHW) CHW can bridge cultural and linguistic barriers CHW expand access to coverage and careCHW improve health outcomesCHW decrease cost of care to the community

Reference 1 & 6

Interventions for this Population (continued)Educate- provide a curriculum at local community college to train as a CHW. Target High School Montagnard seniorsProvide transportation for medical appointments

Reference 1, 4, & 6

Why knowledge about the Montagnard population is important to APNUnderstanding a culture increases awarenessIdentify health issues within the populationUse resources to increase a healthier communityImplement specific care plans for the MontagnardOverall, better management of their healthcare

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Figure 2. Pagonis, J. (2006).

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References1. Community health: No longer a rational argument? (2013). Retrieved from http://youngprojects.blogspot.com/2013/12/community-health-any-simpler-than-this.htlm

2. Finney, R. (2015). Cambodia turns away montagnard asylum-seekers from vietnam [drawing of map]. Retrieved from www.rfa.org/english/news/cambodia/asylum-10012015163053.html

3. Kaleidoscope. (2012). Montagnards. Retrieved fromhttp://cnnc.uncg.edu/wp-content/uploads/2012/08/montagnards.pdf4. Montagnard community struggles to acquire health care. (2014).University Wire.Retrieved from http://search.proquest.com.jproxy.lib.ecu.edu/docview/1624989586?pq-origsite=summon

5. Pagonis, J. (2006). Assistant high commisioner cautiously optimistic over montagnard returnee situation in vietnams central highlands [photograph]. Retrieved from www.unhcr.org/4450f0454.html

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References6. Providers & community-based organizations. (n.d.). Retrieved from http://mnchwalliance.org/chws-you/for-providers/

7. Purnell, L. D. (2008). Traditional vietnamese health and healing.Urologic Nursing,28(1), 63-7. Retrieved from http://search.proquest.com.jproxy.lib.ecu.edu/docview/220152348/DD3478DE41054EBFPQ/1?accountid=10634.html

8. The Montagnards Culture Profile. (n.d.). Retrieved from http://www.culturalorientation.net/library/publications/montagnards-cp9. Xin, H., Morrison, S., Dharod, J., Young, A., & Nsonwu, M. (2014). Cross-cultural "allies" in immigrant community practice: Roles of foreign-trained former montagnard health professionals. Health, Culture and Society, 6(1), 62-72. doi:http://dx.doi.org/10.5195/hcs.2014.143

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