1. Lao Buddhist Case Story UNIITE’s “Health Care and World Religions” series Phase B

2. Lao Buddhist Case Story: A 73-year old male presented by Malcolm Nazareth

3. Malcolm Nazareth Case Story presenter’s profile --Husband of Mariani Nazareth --Co-founder and executive director, UNIITE --Married Roman Catholic priest, serving at St. Mary Community Catholic Church, Harding, MN --part time faculty, St. Cloud State University --Ph.D. in Religion (Temple University, Philadelphia, PA), August ’98 --Hospital chaplaincy training, V.A. Medical Center, St. Cloud, MN, ’99-’01 --Recipient of Anthony Soto Award, July ’06, Rock Island, IL --Many decades’ experience in India and USA as teacher in numerous settings, and facilitator of dialogues between diverse faiths and cultures --Living and serving in Upper Midwest since ’98

4. Lao Buddhist Case Story (1) Male, age 73 Living with 69-year old wife in St. Cloud for more than 25 years Served in Royal Lao army before the Pathet Lao (communist) took over Laos Forced to live for several years in a refugee camp in neighboring Thailand

5. Lao Buddhist Case Story (2) In ’79, moved with wife and 3 surviving kids to Ohio In ’80, finally ended up in St. Cloud, MN, where they raised and educated their kids In ’98, just before he retired, the couple took a loan and purchased their first home

6. Lao Buddhist Case Story (3) Two of the couple’s children married Lao Buddhist spouses and settled in the St. Cloud area One son is a “black sheep,” per Lao Buddhist expectations, and is on his own My info about the Lao senior male subject is from this “unfavored” son—I have never met the subject in person

7. Lao Buddhist Case Story (4) Our 73-year old Lao Buddhist male has never visited a clinic or hospital during all of his decades in the USA His family worries about him because he simply refuses to take western medicine

8. Subject’s unfavored son says (1) Father hasn’t ever been “sociable” (unlike mom) From his early 60s, father has seemed “clinically depressed” Ever since parents moved into their “new home,” father’s isolation and depression have become more noticeable

9. Subject’s unfavored son says (2) Father used to drive, but, ever since retirement, hates to use his car; mom drives him when he simply has to go somewhere Father uninterested in meeting non- family members, or other Lao community members Father doesn’t attend even Lao community celebrations

10. Subject’s unfavored son says (3) Father has health issues, but no primary health physician He consistently rejects/resists any suggestion that he should go visit a clinic When ill, he has recourse to a) herbal remedies from “back home in Laos” and b) Buddha-offerings

11. Subject’s unfavored son says (4) Father “carries a bowl of water outside the building “He sets down the bowl, joins the palms of his hands and closes his eyes for a few minutes—in meditation “His lips move as he devoutly says his prayers. “He then raises the bowl of water skyward to the Buddha “He sets it down and returns to the house”

12. Theravada Buddhist “prayer” an example Buddham saranam gachhami I go to the Buddha for refuge Dhammam saranam gacchami I pay homage to the Eightfold Path I pay homage to the Eightfold Path Sangham saranam gachhami I take refuge in the (Buddhist) community I take refuge in the (Buddhist) community

13. Barriers to health care Language? (Not really; children help out; Bridge World Language interpreters...) Cost? (Not necessarily; Medicare, Medicaid, Mid-Minnesota Family Practice Center, Project H.E.A.L.) Alienness of western health care system? Probably...

14. Alienness of western health care system? Probably... (1) Back in Laos, for decades, our Lao senior was accustomed to Lao native healing traditions and to a society with its well integrated religion and culture There, he also had a choice of visiting some Lao physicians (trained in western medicine) who were far more affordable than here

15. Alienness of western health care system? Probably... (2) If, in St. Cloud, one can use an effective “home remedy” (herbs, spices, teas) put together with natural products available at the local Viet Tien Market or even at Coborns, Cashwise, or Cub Foods, why would one prefer a terribly expensive route (western medicine) with its potentially deadly side effects?

16. Questions worth posing: What factor lends itself (or leads most) to healing? Is it chemicals? Is it drugs? Is it sophisticated western medical knowledge acquired by your typical biomedical specialist? Is it some type of aura around a hospital building?

17. What exactly is our subject’s issue? (1) Is our 73-year old Lao male “mentally ill”? (He’s clinically depressed, probably due to -isolation from community, -haunting memories of war and of dislocated refugee-camp life) Is he culturally alienated? (Although he has lived in St. Cloud for 25 + years, he doesn’t speak English— unlike his wife, who does speak ‘Laoenglish’ quite well, loves gardening, and socializes with others)

18. What exactly is our subject’s issue? (2) Is there “mental” illness that is not intimately related to “physical” illness, age, “spiritual” issues? Are mind, body, and spirit split into different / separate compartments? In Lao Buddhist understandings of health and illness, is there a more holistic / wholesome way of viewing disease, old age, and death which westerners, esp. health care providers in the USA, need to grasp?

19. Perhaps it’s the “western health care system” that needs a “cure”? Despite his family’s concerns, our Lao senior is “hanging on” admirably thanks to indigenous Lao medicine and Buddhist spirituality—he’s a survivor The man’s Buddhist religion and Lao culture are somehow serving him not as barriers but as aids to healthy living thus keeping him from succumbing to disease

20. Our case story would seem to indicate that Some new-immigrants come up with their own resources and survive inspite of the western health care system, not because of it

21. Questions to research further: In St. Cloud area senior centers and nursing homes or retirement homes, is the health care system culturally compatible and religiously sensitive to Lao Buddhist seniors? Given the situation of the Lao Buddhist and other new-immigrant communities, how could the health care system become more “user friendly”? What could cities/counties do now so that Lao families will not get stressed out when their seniors need more accessible end-of- life care?

22. How have medical and social facilities met the religious and cultural needs of Lao seniors? Questions such as these are moot: +ethnic food availability? +Lao language live translators? +ethnic recreation? +access to Lao Buddhist monks? celebrations of life? feasts and festivals?

23. When will we arrive at a system where the best of western medicine will be complemented by the best of non-western medicines in a manner which is affordable and accessible to all?

24. Is an “adjustment” of the western health care medical system long past overdue? When will western health care providers integrate western and non-western styles of health care into “integrative medicine” “new medicine” “new medicine” When will we experience a Copernican revolution in US health care so that the people and not big bucks are “up front and center”?