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Foreword
Executive
Summary
Workshop
1 - The Vietnamese Community
Workshop
2 - Different Service Systems
Workshop
3 - Disability and Health
Appendices
- Summary
of Workshop Evaluations
- Workshop
Participant List
- Workshop
Presenter and Organiser Contact List
- Vietnamese
Community and Media Contact List
- Fact Sheet for
Disability Organisations
Foreword
This report is based on a
series of workshops which developed out of the collaborative
work undertaken by the project partners through the MDAA
supported 'Cultural Diversity and Disability Forum'.
The project arose out of an
understanding by the project partners, that people from a
non-English speaking background (NESB) with disability are
underutilizing disability services and that much needs to be
done to achieve equitable access to services for people with
disability and their families from all ethnic
backgrounds.
Instead of a disability
service going to an ethnic community agency and telling them
about their service, we wanted to educate disability
services about the Vietnamese community; one of the largest
ethnic communities in NSW. The workshops arose out of the
desire by the project partners to communicate greater
knowledge and understanding about cultural diversity to the
disability services sector.
The workshops developed out
of spirit of acknowledging and utilizing the different
expertise available in the disability services sector and
the Vietnamese community. The workshops would not have been
possible without the contributions of all involved, but in
particular the guest speakers from the Vietnamese community
who donated their time and expertise to the disability
services sector, in a most generous spirit which appears to
be so much part of the Vietnamese culture and way of being.
As a way of a thank you, the
proceeds from the workshops ($1,500) were donated to the
Vietnamese Women's Association Special Needs Playgroup.
A word of caution when
utilizing this document to inform your policies and
practice. As April Pham, the President of the Vietnamese
Women's Association highlighted, Vietnamese culture in
Vietnam is different to Vietnamese culture in Australia. The
Vietnamese community, like all other communities (in
Australia, Vietnam and anywhere else), is continually
evolving, changing and responding to ever-changing
environments.
The cultural comments and
'handy hints' contained in this workshop report need to be
seen as a guide only, as something which will aid your
policies and practice, but as with all individuals the key
to best policy, practice and outcomes is to focus on the
individual. This workshop report can assist you in being
more culturally competent in finding out about those
individual needs, wishes and desires.
Vietnamese Women's
Association
The Spastic Centre
Multicultural Disability Advocacy Association
ACROD NSW - National Industry Association for Disability
Services
April 2003
Executive
Summary
It is critically important
for community organisations to work together towards
education and organisational development, in order to
improve service access and build strong cross-sector links
for long-term consumer outcomes. The Vietnamese Women's
Association, The Spastic Centre, Multicultural Disability
Advocacy Association and ACROD NSW developed this pilot
series of three workshops to bring together disability
service providers in South West Sydney. Feedback from
participants highlighted that their expectations of the
workshops were very well met.
The broad objectives of the
pilot were:
- To develop a greater
understanding of the Vietnamese community and the
considerations for inclusive service
provision;
- To provide an
opportunity for workers to gain skills and knowledge to
improve service access and delivery to people with a
disability from a Vietnamese background;
- To provide opportunities
for joint initiatives in South West Sydney to improve
service access, delivery and promotion to people with a
disability from a Vietnamese background.
The workshops addressed the
following ten specific objectives to provide participants
with highly valuable and practical information when working
with people with disability and their families from a
Vietnamese background.
1. To educate service
providers about the Vietnamese community in Australia, with
particular reference to the South West Sydney area.
2. To explore the migration
experience, the role of family, stereotypes, and the
differences between culture, education and employment in
Vietnam and Australia.
3. To look at the
distinction between first and second generations, refugee
and skilled migration, and English and non-English speaking
Vietnamese.
4. To highlight key issues
in communication between individuals and with the government
and service sectors.
5. To explore our underlying
assumptions about the political and service systems in
Australia.
6. To gain insight into the
Vietnamese people's expectations and experiences with
government and service providers, with authority generally
and how mainstream services can consult with the community.
7. To explore perceptions of
people with a disability in the Vietnamese community,
religious and cultural beliefs about disability and the
implications for service provision.
8. To learn about how people
with a disability or chronic illness are treated in Vietnam
and the major health issues for the Vietnamese people.
9. To use the knowledge
gained from the presentations to discuss opportunities for
improving service access, delivery and promotion to people
from the Vietnamese community.
10. To identify practical
solutions and initiatives that services can adopt or joint
projects that will benefit all providers.
Participant
feedback
The rare opportunity for
peer education and networking between the Vietnamese and
other disability organisations was reported as a valuable
experience. Feedback from participants included:
- Case studies were
very practical and informative.
- Excellent discussion
session. Personal stories add to understanding. The
accounts of personal experiences, anecdotal information
and insights from individual perspective.
- The importance of
building trust and offering a service in a clear way;
being patient and persistent.
- Some participants had
difficulty in understanding the Vietnamese speakers
accent and English. This highlighted fundamental language
barriers within the services.
- All speakers were
very interesting and gave an insight into Vietnamese
culture. The guest speaker (father) was wonderful - those
personal insights are very moving - good to have had the
history of Vietnam from previous weeks to put in
context.
- Good ideas generated
in terms of how to access Vietnamese community so they
know services exist.
- Information of the
Vietnamese experience and perspective is both valuable
for service direction, as well as being very
interesting.
- Further discussion on
strategies to address the clash between Vietnamese
culture and disability service standards, which promote
choice.
- The workshops
provided a chance to come up with some concrete
ideas/steps to take next.
Future
initiatives
Workshop participants
identified the following three key areas for future
initiatives, focusing on information exchange between
disability services, the Vietnamese community, and people
with disability from a Vietnamese background.
Initiative 1: Information
on Disability Services for the Vietnamese
Community
Development of a guide to
disability services in South West Sydney, translated into
Vietnamese for broad distribution to the Vietnamese
Community at the New Year Festival in February 2003, via
Vietnamese Community Workers, and through media.
Initiative 2: Information
on the Vietnamese Community for Disability
Services
All workshop documents to be
widely publicised and made easily available to disability
service providers, particularly via the websites of ACROD
NSW, MDAA, VWA and TSC.
Initiative 3: Education
for People with Disability from a Vietnamese
Background
Rights Info workshop to be
run in 2003 by MDAA, Intellectual Disability Rights Service
(IDRS) and the Guardianship Tribunal.
The proceeds from the
workshops ($1,500) were donated to the Vietnamese Women's
Association Disability Project Special Needs Playgroup.
Special thanks to The Spastic Centre for the use of their
venue, The Fairfield City - Marconi Centre,
Prairiewood.
Workshop
1 - The Vietnamese Community - Held 14 October 2002
1.1
Objectives
- To educate service
providers about the Vietnamese community in Australia,
with particular reference to the South West Sydney
area;
- To explore the migration
experience, the role of family, stereotypes, and the
differences between culture, education and employment in
Vietnam and Australia;
- To look at the
distinction between first and second generations, refugee
and skilled migration, and English and non-English
speaking Vietnamese;
- To highlight key issues
in communication between individuals and with the
government and service sectors;
- To use the knowledge
gained from the presentations to discuss opportunities
for improving service access, delivery and promotion to
people from the Vietnamese community.
1.2 Welcome &
Introduction
Speakers: Barbel
Winter, Executive Director, MDAA and April Pham, President,
VWA.
Barbel welcomed everyone and
introduced the workshop partners.
April Pham officially opened
the workshop series by firstly thanking the traditional
owners of the land. April highlighted that Vietnamese
culture in Vietnam is different to Vietnamese culture in
Australia, and the Vietnamese community is continually
evolving, with many subcultures. There is not a single type
of "Vietnamese community", so to improve service provision
and access one needs to understand current values. April
concluded with highlighting the importance and value of
links between the Vietnamese community and disability
services.
1.3 What is Culture?
Speaker: Barbel
Winter, Executive Director, MDAA
"Culture is an abstract
concept that refers to learned, shared patterns of
perceiving and adapting the world which is reflected in the
learned, shared beliefs, values, attitudes, and behaviours
characteristic of a society or population" Fitzgerald et
al., 1995.
As an introduction to the
series, workshop participants discussed the meaning of
culture and identified the diversity and the many different
sub-cultures which are part of Australian culture.
1.4 The Vietnamese
Community - Overview
Speaker: Alice Thai,
Ethnic Health Worker, Bankstown Community Health
Centre.
Alice has been working for
nine years as an Ethnic Health Worker at the Corner Youth
Health Service (a team of Bankstown Community Health
Centre). Her main target group is Vietnamese young people
and their families. Her background is community welfare and
bilingual community educator. Alice has also been involved
with the Vietnamese Women's Association for the last ten
years and currently is its Treasurer.
Presentation Summary -
Alice Thai
Alice's presentation drew
attention to the concern that the Vietnamese community in
Australia have a history of struggle and survival. There are
people even today in Vietnam who are in prison because of
their religious or political beliefs. Since the 1970s, 1
million Vietnamese refugees died along the journey to escape
Vietnam, and 1.5 million were resettled in countries
throughout the world. Currently in Vietnam, there are no
government funded social welfare services, and many
international aid organisations provide services.
Migration
Process
The Viet people arrived in
Australia from time to time and under different
status.
Before 30 April 1975:
Students; Adoption; Spouses of Aussie Servicemen; Approx.
few hundred. A year after the fall of Saigon there were only
2,427 Viet-born residents (census 1976) but the Viet-born
population increased dramatically and continuously through
the four subsequent census: 41,096 (1981), 83,028 (1986),
121,813 (1991) and 150,941 (1996). In that there are 46,756
second generation of people from a Vietnamese background.
People left Vietnam by boat and by walking (to
Thailand).
Before 1975: the
Vietnamese community in Australia hardly existed, apart from
a few hundred who settled here as students from South
Vietnam as temporary residents or through adoption and
spouses of Australian servicemen.
In the late 1980s, the
Vietnamese government had an open policy, so that many Viet
can come back to Vietnam for a visit and the UNHCR had
stopped the refugee status of the Vietnamese people, there
were not many Viet people arriving Australia as refugees
since then. However students: from both South and North of
Vietnam. Children from rich families, tend to stay after
studying. Skilled migrants: There were a few number of Viet
skilled migrants because they have to meet specified
requirement for skill, age, work experience and English
language ability.
Early 90s to present: Status
for migration to Australia included family reunion; Skilled
migrants; Refugees; Students. After the Australian
government established relations with the Vietnamese
communist government, they are most Viet migrants under the
family reunion program come to Australia to join their
refugee members of the family. Although they are migrants,
most Vietnamese Australians consider themselves refugees
from Vietnam (they joined together in any political events
i.e. demonstrations for human rights in VN, signing
petitions).
Why Did People Leave
Vietnam?
- Belief of good education
- Assumption: good to have education in a foreign Western
country, esp. America, Australia, France… then can
be well-educated, have good job with high social
status.
- Seek freedom - Apply to
the refugee status: not much freedom in Vietnam.
- For the future of their
children - they believe that their children won't have
good future under the communist regime. So they had to
take risks in escaping from Vietnam in spite of
danger.
- Fear of prosecution -
for those who worked for the former South Viet Government
and their relatives.
- They faced extreme
hardship in Vietnam like education, job, and
jail.
- "Religions are
poisonous", only like people to believe the Communist
Party.
Risks for
Refugees
- Starvation/dehydration
(there were some boats didn't have enough food for the
whole boat - people would have to eat the dead bodies or
die from hunger unless they received any food supplies
from other ships or places on their way).
- Raped/killed/robbed by
pirates. They believed that the Vietnamese people on
their way to escape had brought a lot of gold or other
valuable things. Many Viet girls had been taken away to
sell for prostitution. There was an estimate of more than
1 million Viet people who died on the way to freedom,
compare with approx. more than 1.5 million people who
settled down successfully in the third
countries.
- Ill health (overcrowded,
stayed on the boat for many days).
- Sea storms (left with
unseaworthy boats and without watching for weather
forecasts). I have my Physics teacher who escaped with
his wife and a friend on a sampan.
- Loss of direction (due
to escape, sometimes they left the captain behind, no map
or compass. So they got lost in the sea and found nowhere
to go, lack of food & water).
Migration
Issues
- Disrupted education:
- Escaped when were young
or born in the camp - Stay in refugee camp so long, no
proper school.
- One parent came to
Australia first, left spouse and kids behind with poverty
- can't afford to go to school, drop school to work. In
Australia, they were put in class associated with age -
can't catch up.
- Language barrier:
Vietnam was dominated by the French for almost 100
years while Americans had been there for about 20 years.
Therefore not many people, especially the first
generation, can speak English fluently. Language barrier
is one of the things that kept them from adapting into
the new society.
- Unskilled jobs
due to the qualifications and work experiences were not
recognised in Aust. English proficiency is also a big
problem.
- Financial
difficulties: Traditionally when someone came to
Australia, they had to send most of their savings back to
Vietnam to help relatives or pay the debt owed to get a
place in the boat. There is not much money left to live
on.
- Traditional food:
Not many Vietnamese people, especially the first
generation, can eat western food on a daily basis. Now we
can find in Cabramatta, Bankstown or Marrickville a lot
of Viet food stores. On the weekends, many Vietnamese
people go to shopping in those areas for traditional
food.
- Culture shock:
Australia is a multicultural country, you can see how
different among those cultures. Vietnamese people need
time to adapt those cultures for fitting in.
- Change in family
structure: the traditional extended family has
changed into the nuclear one, which consists of parents
and children - can cause confusion to them. The changing
role is also a significant cause of difficulties of the
migration process for Vietnamese people.
- Lack of extended
family supports: in Vietnam, there was no social
welfare system like in western countries. To seek help,
they can easily turn to their relatives or neighbours. In
Australia, there is no such a source like this and they
don't feel comfortable seeking help from the strangers.
They might feel isolated and alienated.
- Acclimatization:
coming from the totally different culture, they have to
adjust a lot to adapt into the new society. Like the
other migrants from other countries, most of them,
especially the first generation, still think of Vietnam.
They are thinking one day they can have a free Vietnam,
so they can come back and live in there. Therefore, they
might not accept that Australia as their permanent
shelter.
- Conflict between 1st
& 2nd generations: 1st try to keep the
traditional values while the 2nd want to adapt into the
new society. So it may cause conflict.
- Negative media
assault on identity: like any new migrant group, the
Vietnamese community is easily the target of the media
when there is something happening. For example,
Cabramatta is now well known as a place that heroin is
sold cheaper, purer and easier and so on.
- Awareness of existing
services: After 20 twenty years of resettlement in
Australia, their awareness of services available is
somehow limited. It is explained that they came from the
country where there is no social security system like
Australia, so it takes time for them to getting to know
the existing services. Language barrier is also another
thing to make them reluctant to seek help.
Stereotypes (which some
Viet people might agree/not agree)
- Keen of
study/achievements: it is easy to recognise that the
Vietnamese young people have a lot of achievements in
academic results. Every year many Vietnamese students are
in the top of HSC marks. Today there are 980 General
Practitioners, 450 dentists, 200 optometrists, 100
solicitors, 150 accountants and more in other fields of
activities. The Vietnamese Community has successfully
resettled in Australia with over 80% in paid employment
despite a large number being without formal skills and
qualifications.
- Good in Maths &
Science: I only agree that there are a quite number
of Vietnamese students excellent in Maths and Science but
not all of them. Some Vietnamese parents believed in that
assumption to pressure their kids to be good in Maths. No
wonder now many Vietnamese students go for tutoring. I
consider that English with the students is still hard
while Maths and other Science Subjects are mostly based
on the facts and don't use much English. So they tend to
focus more in these subjects to get high
marks.
- Hardworking/perseverance:
Looking at the history of Vietnam, we never stay in
peace for long, most of the time we had to fight either
with other countries or civil war. During war the economy
system is deteriorated. Therefore after war, we had to
work very hard to rebuild the country. It is similar when
we moved to another country, empty handed. No wonder why
the hardworking/perseverance assumption goes with
us.
- Keeping to oneself:
Living in VN where the family value is more important
than the individual's one, Vietnamese people were taught
to show good things off and hide bad things away.
Therefore they used to keep things inside and try to
solve the problems themselves or with the close family
members. They tend not to disclose their problem with
outsiders until they can't handle it any more. They don't
want to lose face or the honour of their families.
Fortunately, Viet people gradually are used to
counselling services through the help of bilingual
workers.
- Timidity: When
young, Viet person was not encouraged to talk back or
even be talkative, especially woman; Good kid should
listen and obey only. There is a proverb that every
Vietnamese know 'Bend your tongue seven times before
talk' that made Viet people to be timid or not be active
in a conversation. Of course, I did not mention the young
generation that is educated here. They were easily and
quickly express their ideas or stand up for their
opinions. There are some complaints from
parents/grandparents about young people answer back
impolitely.
- Superstition:
Have you known about Feng-Shui? Vietnamese people
also believe in that. My dentist is facing some problems
about his business and family, so he asked a Feng-Shui
expert. Eventually he is spending quite lot money to
renovate his house. But who is sure that his problems
will go away. Even in the Buddhist Temple, people go to
worship the Buddha; there is also a place that they can
get a piece of lot paper to tell them how good or bad
they will be depending on their questions. When a member
in the family is sick, especially with mental illness,
they take that person to a sorcerer/magician to
treat.
- Used imported cars
(especially Japanese or European) There is a belief
that car made from those countries are high in quality,
long lasting and with nice body (Jap). One day if you go
to Cabramatta, you will see most of the cars driving by
the Viet/Asian people are made in Japan; European cars
were less used due to the higher price.
- Shoes-off before
entering: Vietnamese people tend to take their shoes
of before entering the houses as they don't want to bring
any mess or dirt into house. Visitors are not asked to
take their shoes off but by doing that you can show a way
of subtlety and respect.
Further
Information
To assist in understanding
the Vietnamese community, Alice recommended that
organisations read accounts in the following two books about
true stories of Vietnamese refugees:
- "Refugee, the Vietnamese
Experience" (1982) Edited by Lesleyanne Hawthorne.
Oxford.
- "Journey to
Freedom"(1999) Federation of VWA.
1.5 The Vietnamese
Community - Some Cultural Differences
Speaker: Hien Le,
Coordinator, Vietnamese Women's Association
Hien Le has been working as
a Co-ordinator/Community Settlement Services Worker for VWA
for almost five years. Prior to that she worked for the
Vietnamese community in South Australia as a family support
worker for ten years and also worked part time for Child
Youth Health Services in Adelaide as a Bilingual Community
Educator for five years. Hien's background includes: Science
(Biology), Computer (System Analysis) and Social
Administration.
Presentation Notes - Hien
Le
In assisting service
providers to improve the accessibility of the Vietnamese
community to their services, this presentation aims
to:
- Increase awareness of
service providers about the cultural
differences;
- Avoid misunderstanding
or feeling frustrated, irritated, offended etc. when
working with people from a Vietnamese
background.
Some cultural
differences:
- 'Chao' (Hello) can be
used for greeting.
- 'There are no polite
formulas equivalent to 'good morning' in Vietnamese'
(Austcare, 1977: p7.167).
- When greeting someone,
slightly bow the head, and join hands in front of the
chest in order to show more respect.
- Vietnamese males usually
shake hands. Vietnamese do not shake hands with opposite
sex, or elders unless they offer their hand
first.
- Never exchange
cheek-kisses.
- Vietnamese greet the
older person first, then the younger ones.
- 'The writing order of a
Vietnamese name is the reverse of the Australian name'
(Cultural Background Paper, Dept of Education & Youth
Affairs - p13). Surname comes first, middle name is in
the middle, given name comes last e.g.
Surname Middle name Given name
Tran Van Dung
Nguyen Thi Kim Loan
- "Van" for the middle
name indicates a male name and "Thi" for the middle name
indicates a female name. After marrying, women still keep
their family name.
- 'Whether a Vietnamese
agrees or disagrees with the speaker, response always
start with "Yes" (mean "da" in Vietnamese). "Yes in
Vietnamese means that they are listening, paying
attention to the speaker. In listening to the response of
a Vietnamese, it is best to ignore the initial "yes" and
concentrate on the following statement in order to
interpret the answer". (Cultural Background Paper-
Vietnam, Dept Education & Youth Affairs -
p14).
- Any emphatic "no" is
thought to be impolite.
- Smiling at all times and
places are common characteristics of all Vietnamese.
Vietnamese smile about almost everything and anything. It
can be used as a polite screen to hide confusion,
ignorance, feat, contrition, shyness, bitterness,
disappointment or anger. There are no guidelines to tell
the meaning of each smile in each situation. People from
other cultures need not feel frustrated, irritated, or
offended at not being able to guess its exact meaning
(Cultural Background Paper- Vietnam, Dept of Education
& Youth Affairs - p14).
- 'In answer to praise,
Vietnamese usually say that he or she did not deserve it'
(Cultural Background Paper - Vietnamese, Dept of
Education & Youth Affairs - p14).
- The shyness or avoiding
eye contact when talking to elders or superiors in status
or position may be described as to show respect or
politeness to them;
- Vietnamese tend to be
more reserved than Anglo-Australians, relying on
listening, watching and imitating than on experimenting.
Looking into someone eye when talking can be considered
as rude or aggressive attitude, especially when talking
to elders or superiors.
Things which are
generally acceptable:
- Physical contact between
men or between women is very common, eg. two women (or
two men) holding hands in the street
- Wearing pyjamas during
the daytime or in public
- Vietnamese can share a
bed with the same sex
- Children can sleep with
parents, not everyone owns a bed
- Children stay with
parents until married.
Things which may not be
generally acceptable:
- Touching, kissing or
showing affection (between husband and wife, lovers or
those of opposite sex) in public or in front of
children
- A couple living together
before marrying
- Speaking or laughing
loudly in public
- Expression of anger or
frustration, joy fully or excessively in
public
- Children answering back
or expressing anger to parents or elders (as children are
brought up to treat parents with politeness, obedience
and great reserve).
In
general:
- Offer drink or food to
visitors without asking if visitors would like to have
one or not
- Vietnamese people offer
to pay all the cost if inviting guests to a restaurant or
a party. If he or she is invited he or she may not
pay.
- Vietnamese talk around
and around a subject before coming to the
point.
Popular festivals and
celebrations:
- New Year Festivals
(Lunar New Year): celebrating with traditional dishes,
new clothes worn, exchange gifts and lucky money put
inside the red envelope for children, wishes of
happiness, prosperity, good health, peace and
longevity
- Moon Festival or
Children's Day: the 15th day of the 8th lunar month,
celebrating with moon cakes, lanterns and other fun
activities
- Anniversary of the death
day: worship ancestors, having a big meal, family members
get together and talk about the good aspects of the dead
person.
References:
- Dept. of Education &
Youth Affairs - Cultural Background Paper - Vietnam,
Commonwealth of Australia, Woden, ACT, p13-14
- Dept of School Education
South West Region - Cross Cultural Awareness
- Hassan, R: Healy, J:
McKenna, R.B: Hearst, S. (1985) - Vietnamese Family, in:
Des Storer Ethnic Family Values in Australia, Australia:
Prentice Hall
- Nguyen Kin Hong,
Understanding Cultural Differences Between Americans and
Vietnamese, New York: Board of City of New
York
- University of Sydney,
Research Institute for Asia and the Pacific, The
Vietnamese Community in Australia
- Austcare (1997)
Education project - Vietnam, p7.167-179
Discussion
Workshop participants
discussed the following questions of
protocol:
Meeting and greeting
parents of children - by what name should workers call the
children?
Answer: If service
providers are confused about how to address Vietnamese
people, ask them what they would prefer to be called. It was
noted that Vietnamese people in Australia generally change
their cultural forms and use the same structure for first
and surnames as is used in Australia. Call children by their
first name only. In Vietnamese way we have words to call
them like 'young brother' or 'little sister' or even call
them 'children'.
Home visits - how can
workers improve communication to help parents gain a clear
understanding of the service?
Answer: At home the
fathers often take a step back in individual planning.
Workers will usually just talk to mothers, who will then
tell their husband later. Many Vietnamese men still like to
talk to the workers if they have good English and
confidence. Other cases, workers can directly invite men to
join the conversation, I think they'll be happy to join in.
If not, don't worried, just talk to women.
Protocols for drinking
tea - who sips first?
Answer: For family -
older people usually to be invited and drink first, for
guests I think to be polite, workers can just invite them
back and drink, do not need to wait for them to sip
first.
Asking family members
questions - it often feels like the organisation is prying
into private affairs, even though they are just generic
questions about service provision. How do services know how
much or how little to ask?
Answer: Workers can
ask questions indirectly by guiding them to tell you their
story, not so straight forward to each question as it may
make them feel to be interrogated or pry into private
affairs. Building trust is very important, when families get
to know workers more, they may be more likely to answer
questions about service needs, and workers may not need to
ask.
1.6 The Vietnamese
Community - Vietnamese Cultural Identity
Speaker: Tam Nguyen,
Bilingual Mental Health Worker
Tam is a Bilingual Mental
health worker and has been in this position for six years.
Before this time, she worked for the Indo-Chinese Women's
Refuge as a Child Support Worker. Tam's background includes
a Vietnamese Interpreter and Community Organisations (Dip).
Her favourite area is empowering people to live a happy life
and to find a meaningful life wherever they are.
Tam's presentation
highlighted that Vietnamese people in Australia have to
struggle with two cultures. Tam has decided to adjust,
adopt, and accept the two cultures, and she allows her
children to make cultural choices for themselves. Tam gave
an overview of how she has adapted the Vietnamese cultural
norms in her life. These changes focus on equality and
respect between all family members; empowerment for women;
and encourage children to be independent and speak about any
problems.
Presentation Notes - Tam
Nguyen
In Vietnamese culture, the
individual's interest and destiny are rarely conceived
outside the framework of the immediate and extended family.
Anything the Vietnamese person does, it usually done out of
family consideration rather than for their individual
interest.
From early childhood,
Vietnamese are taught to live in harmony. This norm is very
important for every family, particularly large families.
Each family member must know how to make concessions for
each other to achieve the family's ultimate goal of
happiness.
Strong and extremely complex
bonds of filial respect combine with parental responsibility
to provide support and guidance in a wide-ranging kin
network. Moderation and caution in speech constitute a
distinctive feature in Vietnamese culture (to answer only
when spoken to and show respect towards one's elders). This
attitude is partly prompted by the belief that wise and
talented people are modest in action and speech. Bragging
reflects an empty soul. It is commonly believed that hasty
words and slips of tongue are as devastating as hasty
actions and bad deeds.
Vietnamese people are
reserved, non-responsive and non assertive by Australian
standards; this is particularly true with the behaviour
of Vietnamese children in school in which they rarely
volunteer to answer questions for fear of being mistaken as
trying to "show off". They have been taught "to talk only
when talked to and answer only when talked to". This
attitude is also aimed at "saving face", should the answer
be a wrong one.
Value system: The
Vietnamese value system is based on four basic factors:
allegiance to the family; yearning for a good name; love of
learning; and respect for each other.
Allegiance to the
family: the most important component in the value system
of Vietnamese people is the family, the family is seen as
the backbone of Vietnamese society. Each individual strives
to be the prize of their family. The misconduct of an
individual is blamed not only on oneself, but also on their
parents, relatives and ancestors (and reverse). The
Vietnamese child is taught at their very young age to
readily forget themselves for the sake of their family's
welfare and harmony. Central to the concept of family is the
obligation of filial piety, which is considered the most
essential of all virtues in Vietnamese society. The child
ought to be grateful to their parents for the debt of birth,
rearing and education by the parents.
The profound love for, and
attachment to the family is extended to the physical setting
in which the family exists (resides, lives); the native
village. It is not only the place where the individual is
born and brought up and where their parents and family live
but also the place where their ancestors are buried. Many
Vietnamese, especially people in the rural areas, never move
out of their native village or province.
Good name: or more
precisely "fragrant name" as it is said in Vietnamese
language. To the Vietnamese, a good name is better than any
material possession in this world. It is believed that the
best thing that a person can leave behind after death is a
good reputation. "A tiger leaves behind his skin, a man his
reputation", says a proverb.
There are three ways in
which a person can acquire a good name: either by heroic
deeds; by intellectual achievements; or by moral virtues
(among those three, leading a virtues life is the easiest
and surest path to a good name). The virtues most cultivated
are a sense of honour, honesty, righteousness, modesty and
generosity. It is not surprising to know that the Vietnamese
person strives for a good name not only for themselves but
for their parents and children.
Love of learning:
The Vietnamese have a great admiration and willingness to
acquire knowledge and learning. People with knowledge and
learning, such as scholars, writers and teachers are highly
respected. Learning is considered more valuable than wealth
or material success. Education represents the essential
stepping stone to the social ladder and good job
opportunities.
The concept of respect:
A Vietnamese person is expected to show respect to
other people who are senior to them in age, status, or
position. In family, they should pay respect to parents,
older siblings and other relatives. Where grandparents are
still alive, children and grandparents have the
responsibility to look after them with total loyalty of
heart and with great devotion. Outside the family, respect
should be paid to elderly people, teachers, monks, and all
people having high social status like medical doctors and
lawyers. The younger generation has to acknowledge their
ancestor's contribution. The proverb: "Our ancestors had
built the country, we have to respect our country" has
explained the strong link between generations.
Sex roles: Despite
modifications in recent times, respect is still granted the
head of the family (male) and to other males in the family.
The head of the family, is traditionally the sole income
earner and the central power base in the family. The
parental male role is provider and judge and public upholder
of family honour through his social interactions. A man may
also play the role of severe father towards his children. In
the process of educating children, the parents, especially
the father, and the teachers at school can use any method
they see fit to facilitate learning, including beating with
a stick.
The saying "husband is king,
wife is servant" clearly reflects the sex differentiation in
Vietnamese culture. Women are traditionally subservient to
men and are taught the three degrees of dependence: before
marriage to depend on their fathers; after marriage to
depend on their husbands; on becoming a widow they depend on
their eldest son. In the past, only the sons were encouraged
to pursue their education, daughters mainly stayed home and
helped their mothers in cooking and house work. Daughters
are taught four qualities: proper skill; proper demeanour;
proper speech; and proper manners. The admired
characteristics of Vietnamese woman are revealed by
traditional sayings, which emphasise her ability to endure,
suffer, and sacrifice. Events in Vietnamese history have
also put other roles on woman such as taking over the family
business while the father is away, and extending her serving
toward in-laws family.
Children: At an early
age, children are taught by their parents and relatives to
behave according to the principals of filial piety and
social courtesy. The family is the school where the child
learns the respect rules in both behaviour and linguistic
response. The cornerstones of children's behaviour in the
family are filial piety that consists of loving, respecting,
and obeying ones parents, chiefly in their old age.
Vietnamese elderly people never live by themselves or in
nursing homes but with one of their children, usually their
eldest son.
Conclusion:
Since 1975, following the
communist takeover of the whole country and the tragic
exodus of the Vietnamese people throughout the world to
search for freedom, the Vietnamese family has become
increasingly broken and dispersed. Husbands and wives,
fathers and sons, mothers and daughters live thousands and
thousands of miles apart. But despite all this, deep
feelings survive, ties are still strong and the Vietnamese
family still survives through time and change.
References
- University of Sydney,
Research Institute for Asia and the Pacific, The
Vietnamese Community in Australia
- Nguyen Xuan Thu - The
Vietnamese Family Model Code.
1.7 Questions &
Discussion
Are older siblings
responsible for younger children?
- Yes, older siblings put
their younger ones before themselves.
How can we provide a
service for Vietnamese people?
- Educate yourself about
Vietnamese culture.
- Get to genuinely know
the family, ask many questions.
- Invite members of the
Vietnamese community who are part of the community
services sector to work with your service in meeting with
families.
- Some services employ
bi-lingual workers and this helps families feel more
comfortable with an accessible service.
- Language barriers can be
a problem, so services should use an interpreter when
needed.
How hard do you push
someone to use the service, when because of the reserved
nature of the community, they refuse services?
- Sympathise with their
problems.
- Reference research is a
good way to gain a better understanding. See Look into
Our Eyes: Personal Development and Indochinese Students
by Ninh Nguyen, Careforce, 1991.
What can services do when
ageing parents with dementia refuse to accept referrals for
their child with a disability?
- Service needs to build
up trust with the family and explain other
services.
- Transcultural Aged Care
Service - phone 8585 5000
Are attendant care
services acceptable?
- Many families believe it
is their role to look after their own family.
How are support groups
perceived?
- Vietnamese carers
support groups are usually based on religious groupings,
and this is not a conflict with saving face in regards to
children with disability, as everyone participating is
dealing with the same problem.
- Vietnamese speaking
(rather than English-speaking) support groups are very
important.
Workshop
2 - Different Service Systems - Held 28 October 2002
2.1
Objectives
- To explore our
underlying assumptions about the political and service
systems in Australia.
- To gain insight into the
Vietnamese people's expectations and experiences with
government and service providers, with authority
generally and how mainstream services can consult with
the community.
- To use the knowledge
gained from the presentations to discuss opportunities
for improving service access, delivery and promotion to
people from the Vietnamese community.
2.2 The Service System in
Vietnam - Implications Australian Organisations
This information has been
provided (with much thanks) by a person who wishes to remain
anonymous.
Some Facts about
Vietnam
- Population (2001)
= 78.7 million, Urban = 24.8%, Rural = 75.2%. Population
density = 237.6.
- Land Area =
331,114 square kilometres.
- Economy: Vietnam
is one of the poorest countries in the world. People
below International poverty line = 37%. Exchange rate
US$1= Dong 14,785. GDP per capita = US$ 416. Sectoral
share of GDP: Agriculture = 23.3%; Industry and
Construction = 37.7%; Services =39.0%
- Health: Life
expectancy = Men, 66.6 years; Women, 70.2 years. Infant
Mortality Rate (per 1,000 live births) = 31. Public
spending on health = 0.8%. Hospital beds (per 100,000
people) = 50. Drug addicts = 135,000. People with drug
addiction have to go to two-year re-education camps.
However, 90% of people released become addicted again.
People living with HIV/AIDS = 200,000.
- Education: There
are now between 50,000-100,000 street kids in Vietnam.
There are only 10 universities in Vietnam. This makes it
difficult for people to go on to further education.
During Chinese rule, Vietnamese people used Chinese
writing. In the 17th Century when missionaries came to
Vietnam, Latin alphabets were used to write down the
Vietnamese spoken language. There is now 94% adult
literacy. Primary spending on education = 2%. Primary
school completion rate = 66%. Net primary school ratio
(2000) = 92%. Net lower secondary school ratio = 74%. Net
upper secondary school ration = 38%.
- Communication and
Technology: Many people in Vietnam today do not have
access to basic technologies such as computers and
television. Paved roads (2000) = 25.1%. Telephones (per
1000 people) = 32. Television sets (per 1000 people) =
47. Personal computers (per 1000 people) = 6.4. Number of
Internet subscribers (February 2001) =
114,800.
Service
System
Government
services
In Vietnam, government services are generally for people who
belong to the Communist Party, which continues to be in
power today. It is felt that they take good care of
themselves, but there is nothing for those not in the party.
The Communist government looks after the wealthy, and does
not redistribute wealth in an equitable way. There is no
accountability about where government funds are spent - it
is common knowledge that very little government funds go to
the people. There is no effective taxation administration
system.
Vietnam has a culture of
corruption at all levels of government. From 1986 until now
with the reconstruction of the country, corruption began to
increase as funding from international assistance came into
the country. Principal Vietnamese Government Services are:
Health; Education; Ministry of Labour, Invalid and Social
Affairs; Local and National Administrative Authorities and
Branches.
Private medical insurance
has recently been introduced. It is to help people when they
go to hospital, but there is no general Medicare system, so
user pays. This means that many people will only see the
doctor in extreme health situations.
Non-Government
services
There are only a limited number of non-government
organisations in Vietnam, many of those are international or
overseas NGOs such as - Vietnam Red Cross; ROMAC; Fred
Hollows Foundation; Religious Charitable Groups and some
other foreign organisations. They help with a range of
support services including assistance with flood, fire, and
typhoon relief. Religious organisations also provide social
and educational services, however religious freedom is not
always guaranteed.
Vietnam people's
experiences with Government
In general people's experience with government is one of
caution. The Communist Party is the only party in Vietnam,
and they control all aspects of life. There continues to be
human rights violations with people imprisoned for their
religious and political beliefs and activities. Essentially
there is no free speech, no freedom of the press and no
religious freedom.
Implications for the
Vietnamese in Australia
There are approximately 175,000 Vietnamese in Australia.
Most Vietnamese in Australia are refugees, not migrants
(language barrier). As refugee many were not prepared when
they had to leave Vietnam. As a country which had been close
ties with France, many people escaping in the 1970s and 80s
had planned to go there, as many were
French-speaking.
Experiences with Vietnamese
government still influence Vietnamese people in Australia.
For example, many people will still listen to government as
the authority; don't believe they have the right to
complain; and do not trust police. As government cannot be
relied upon, many Vietnamese people are less demanding and
seeking less assistance from other than family members and
close friends.
There is little awareness of
services, as a service system such as the one in Australia
does not exist in Vietnam. The user-pays model of medical
care in Vietnam means that people only seek help in extreme
situations. This attitude is retained in Australia, and
people will only go to a service as a last resource. The
idea to use a service to for early intervention and
prevention is little known.
There are services in
Australia which are new to Vietnamese people. This includes
counselling, and other family support services: counselling
in general; family counselling; domestic violence;
disability services, gambling counselling; drug &
alcohol counselling; child protection; rape/sexual assault.
2.3 Vietnamese Community
and the Australian Service System
Speaker: Thang Ngo,
Councillor, Fairfield Council
Thang gave an overview on
why he became a politician. He came to Australia when he was
nine, and grew up with Vietnamese culture at home, and
Australian culture at school. Thang became involved in
politics when a local government when they tried to close
down a Buddhist temple in Bankstown. This was the first time
the Vietnamese community fought and won! Thang's Dad always
reminds him that they came to Australia for freedom. Thang
was elected on the basis of the Vietnamese community coming
together to raise issues.
Thang's family is from South
Vietnam. Because of the wartime political environment, South
Vietnamese people particularly had to be very resilient to
survive. Implications for today include a cautious approach
to government, and not taking overtly politically actions or
attitudes. Thang was disappointed that the Vietnamese
community did not stand up and support the recent boat
people from Afghanistan, because they arrived in Australia
the same way. Thang highlighted that Vietnamese
representation and participation in government at all levels
is very important for an accessible service system.
Questions &
Discussion
How can services become
more accessible, when they don't have any Vietnamese
clients?
- Services should consult
with Vietnamese organisations, and then those services
can refer to your organisation. Use the Vietnamese media
to promote your service - radio and newspapers. A lot of
older people listen to Vietnamese radio. Some people
can't read Australian newspapers.
- Thang will provide a
list of Vietnamese media contacts for workshop
participants. Up to 86% of the Vietnamese community
listen to the SBS radio program.
What is the best wording
to use to explain what services are?
- The organisation
"Vietnamese people in Australia" will help disability
organisations to prepare information in a clear and
culturally appropriate way.
- A parent's group, with
the use of an interpreter, has been a successful way to
share information about services with
families.
Is there a way of getting
people to say what they need?
- One service uses a
checklist every three months to review equipment and
service needs. It's still difficult to get families to
initiate contact about needs.
- Patience is needed,
because there are big issues with trust between
Vietnamese people and service organisations.
- The disability service
sector works with two generations of people from a
Vietnamese background, and communication issues with
parents need to be overcome.
Is in-home care
appropriate?
- Thang's father would not
allow home care to assist with his sick wife, and did all
the care himself. Thang is not sure why this was, but his
father would not accept home care.
- Organisations need to be
patient when offering services to families.
Is there any way of
assisting in a crisis?
- Sometimes asking for
help in a crisis is seen as shameful for some families.
Health care is often seen as the family's
responsibility.
Should we be educating
doctors about our services?
- Thang agrees that
educating the doctors is a good way to get information
out to the community.
Do Vietnamese doctors
only refer to Vietnamese specialists?
- Thang highlighted that
this is not the case because there are not many
Vietnamese specialists.
- Some families are too
proud to ask for help, and then the anger can build up
and lead to abuse. In the case of a wife supporting her
husband, it is not usual for the man to say thank you or
appreciate the work.
- It is very important for
families to know about what equipment aids are available,
and this is difficult when they refuse to use a
service.
- Barbel discussed that
research in mental health area shows that people from
non-English speaking backgrounds tend to go to General
Practitioners for help and information.
- Thang advised that the
Vietnamese Health Professional Association would be a
good contact to educate about disability organisations. A
magazine is produced each month, and information on
disability services can be advertised.
- It was noted that there
are also Vietnamese festivals held in February and
mid-August each year. Organisations could promote their
services there. One early childhood service had a stall
and saw 400 people in four hours.
Is working with a
Vietnamese worker a better way of getting
feedback?
- Sometimes it does help
to make people more comfortable with the organisation.
However, there are also concerns with privacy amongst the
Vietnamese community, and people may be reluctant to give
information.
How do organisations work
in partnership with families, particularly as the philosophy
of the Disability Standards promote choice?
- Thang emphasised that
service providers need to build up trust before
Vietnamese families will take initiative and make choices
about services.
Once the trust is
developed, some services experience that the family want
them to make some major decisions and take leadership in
areas outside the scope of service delivery - e.g. legal
issues.
- Thang explained that
services need to be clear and explain how the service
system works, even though this can be
difficult.
- Barbel highlighted that
taking the time to learn about the family and build up
the trust is an important way to avoid later
conflict.
Is there a community
hierarchy in the Vietnamese community?
- Thang discussed that
nothing is fixed until the ground-rules are set, and even
then things can change. There is no hierarchy, but
respect is given to particular people. This is not set -
it could be a monk, an uncle, a child, a doctor,
etc.
Workshop
3 - Disability & Health - Held 11 November 2002
3.1
Objectives
- To explore perceptions
of people with a disability in the Vietnamese community,
religious and cultural beliefs about disability and the
implications for service provision.
- To learn about how
people with a disability or chronic illness are treated
in Vietnam and the major health issues for the Vietnamese
people.
- To use the knowledge
gained from the presentations to discuss opportunities
for improving service access, delivery and promotion to
people from the Vietnamese community.
- To identify practical
solutions and initiatives that services can adopt or
joint projects that will benefit all
providers.
3.2 Vietnamese Community -
Attitudes Towards Health
Speaker: Anh Le,
Bilingual Health Worker, Fairfield Mental Health
Service
Anh Le has worked at FMHS
for the last seven years. Her roles include case management,
crisis intervention for adult mental health clients and the
health educator to facilitate early intervention. Her
Background is in community welfare, with experience in
children's services, child protection, community education
and community management and development.
Presentation Notes - Anh
Le
Barriers to accessing
health services
- Lack of understanding
and trust in modern medicine
- Lack of understanding
and access to services
- Negative attitude toward
authority figures
- Difficulty expressing
unhappy feelings and emotion.
Difficulties with
communication
- Language barriers and
problems with interpreters translating information for
assessment.
- Feeling embarrassed when
using translators in dealing with personal
issues.
- Trust between
interpreters and patients - especially if interpreter is
from North Vietnam, and client and their family is from
South Vietnam. Services need to understand the
significance of how different interpreters can affect an
accurate assessment of need.
- Other interpreter issues
including: confidentiality; clashes with interpreter's
gender; or political background.
Difficulties within the
family and community
- Negative attitudes from
the community in response to a family member with a
disability can lead to isolation because of shame and
wanting to protect family name.
- Conflict between family
and patient about treatment.
- Non-compliance to
treatment due to side effects and lack of
understanding.
- Patients left untreated,
and become severely ill.
- Young children can be
neglected or abused.
- Family
breakdown.
- Involuntary treatment
orders are generally supported by families who can no
longer support the person with a mental
illness.
Cross cultural health
service
- Provide links between
clients, family members and appropriate mainstream
services, and support groups.
- Advocate on behalf of
and provide information, culturally appropriate
counselling and support to clients and their
families.
- Provide information to
mainstream services on cultural aspects.
- Organise community
education programs to raise awareness about disability;
encourage early intervention and treatment; challenge
negative attitudes; and encourage more community
tolerance and support for people with
disability.
Current
treatment
- Medication - recent
research has shown that there can be different side
effects to the medical treatment for people from
different cultures.
- Therapy, counselling,
rehabilitation activities and educational
programs.
- Traditional
healings.
- Meditation, praying,
ritual practices.
- Relaxation, exercise,
special diet.
Discussion
- There is an assumption
by some Anglo-Australian communities that people from
other cultures will look after their own. However
everyone should have access to support
services.
- Ageing issues -
Vietnamese people seem to be more tolerant about ageing
related disability. There is family care, and elders are
treated with much respect.
- Employment for
Vietnamese people with disability is encouraged by
support services, but the language barrier is a problem
to overcome. 2nd generation Vietnamese people with a
disability who do have the language skills are accessing
employment opportunities.
- Some families don't know
that a family member has a mental illness or other
disability.
Case
Study 1 - Mr Z, Carer Perspective
Guest speaker: Mr
Z.
Facilitator: Anh Le.
Interpreter: Tam Nguyen.
Mr Z's family immigrated to
Australia in 1991. Mr Z's son (Mr A) is 43, and has both a
mental illness and physical disability. Mr A goes to
rehabilitation centre twice a week. The rest of the week, he
is at home, and Mr Z is the primary carer. Other children in
the family help with support.
Community workers come to
the house when extra support is needed. Mr Z administers Mr
A's medication every day - there are about 10 different
tablets. The doctor has explained the purpose of each
tablet, and Mr A translated this explanation into Vietnamese
for Mr Z. However, when Mr A is not feeling well, he does
not speak English. It does not matter to Mr Z that the
Doctor is not Vietnamese, it only matters that he is doing a
very good job.
If they still lived in
Vietnam, Mr A would not have access to the same health and
support services in Australia, and may have died by now.
Additionally, in Vietnam, the family would have been blamed
for the mental illness as a result of bad karma. The family
appreciates all the support from the services - karma is an
issue in Vietnam, but not in Australia
Difficulties faced by the
family
- As a result of the
medication, Mr A wets the bed every night. It is very
hard as ageing parents to wash and clean the bed each
day. Mr Z is 76 years old.
- Mr Z doesn't speak
English, so it is hard to call the ambulance in
emergencies.
- Mr A is overweight
(about 90 kilos), and will not listen to family advice.
Diet counselling is needed.
Services
- Mr Z found out about
support services because his son was sick, and they
needed to find help. In order to find different types of
services, Mr Z would ask his existing support workers. Mr
Z does not listen to community radio to find out about
services.
- It is not important that
the support worker is Vietnamese - anyone coming to help
the family is welcome.
- The quality of service
is more important than whether or not the worker or
Doctor is from the same cultural background
3.3 Vietnamese Women's
Association Disability Support Project
Speaker: Kim Huynh,
Disability Support Worker, Vietnamese Women's Association
(VWA)
Kim's education includes a
degree in Community Welfare from the University of Western
Sydney, and a Bachelor of Agriculture from the University of
Saigon. She has worked for Flinders University (South
Australia) as an interviewer for their Vietnamese Mental
Health Wellbeing Project and for the Multicultural Family
Support Program at UnitingCare Burnside Cabramatta
Centre.
Kim presented the following
summary of the VWA Disability Support Project. Kim's
position is only funded for one day per week. This means
there is only limited time to do individual casework. Kim
runs two group work sessions per week, for parents and
children with special needs, Rose's Group; and a Mental
Health Support Group. Issues for Rose's Group - there is no
funding for toys or assistance with transport costs. There
are comparisons with the Burnside children's playgroup,
which has more resources.
VWA Disability Support
Project (DSP)
The DSP has been funded by
the Community Relations Commission (formerly Ethnic Affairs
Commission) since 1999. The aim of the project is to assist
Vietnamese people who have disabilities to gain access to a
wide range of available disability services and community
resources. The worker-funded hours (one day a week) are
inadequate to meet the needs and demands of the clients.
Activities undertaken by the project:
- Casework: Face to
face at VWA, on the phone and home visiting.
- Group work:
Mental Health Support Group; and Parents and Children
with Special Need's Group.
- Community
development: workshop and seminar on health issues
and disability services.
Health Related
Problems
During 11/2000 - 9/2002, a
total of 78 cases at two family support services for the
Vietnamese families, there are about:
- Autism 10.2% (children
from 4-14 yrs)
- Speaking development
delay 12.8% (children under 5.5 yrs)
- Mental health
illness
People on medication 15%
Depression & anxiety 12.8%
- Brain injury
10%
- Bad back 5%
Mental health: In NSW
according to the report written by Prof. Tuong Phan and Viet
Thang Tran (a Psychologist), in the Vietnamese community in
NSW, there are many Vietnamese suffered from depression and
anxiety. "Clinical reports during 1970s and early 1980s
identified the Vietnamese Refugee-Immigrants as being a high
risk group for mental health problems. Anxiety, depression
and somatoform disorders as well as suicide attempts were
observed to be prevalent amongst both Vietnamese adults
(Rahe et al., 1978) and children…." (Information from a
paper is written about the measure of mental illness
developed by Prof. Tuong Phan in 2000). The results from the
research of Viet Thang Tran show that 37% of Vietnamese
people in NSW have mental health problems in comparison to
3.9% of English speaking people.
Brain injury:
Commonly acquired during car or work accidents, and
throughout the Vietnamese war in refugee camps and escaping
the country.
Bad backs: Commonly
the result of hard work and lack of knowledge about how to
protect their back properly in the community.
Difficulties with
Accessing Services
- English
difficulties: most clients preferred casework rather
than group work. Vietnamese bilingual workers and TIS are
needed to access English speaking services).
- Cultural issues:
including hidden problems, saving face, low self
esteem.
- Lack of information and
knowledge to access disability services.
- Lack of knowledge to use
disability services in Vietnam as well in
Australia.
- Resources e.g.
limited funding of the project at VWA compared with other
services like Sharecare, DOCS, Anglicare; waiting lists
for family support and case manager by DOCS, large
waiting lists to see speech pathology.
"There are VERY LITTLE
services for disabled people here…Schools are just
emerging: curriculum for special schools are just being
created.. There is very little help for those with physical
disabilities: all assistance seems to come from Charity
Associations and NGOs specializing in this kind of
help…"
(Trish Franlin, The
coordinator of a Centre for homeless children and disabled
children in Vietnam).
Recommendations for
services
- Understanding the
cultural issues, the special circumstances of the
Vietnamese refugee-immigrant people, and the problem with
English language difficulties, is necessary to help
Vietnamese people to access disability
services.
- Information needs to be
provided in both Vietnamese and English languages.
Cooperation between Vietnamese bilingual workers and
English speaking workers is required sometimes to achieve
good results.
Case
Study 2 - Casework with Mrs X
Facilitators: Kim
Huynh and Barbel Winter
Mrs X is 34 years old, born
in Vietnam in a very poor family so she did not finish year
three at primary school. She is illiterate even in
Vietnamese. Ten years ago, her husband sponsored her to
immigrate to Australia. She has no relatives in Australia
and only has the in-law family. The first year in Australia,
she felt lonely and was frightened in her flat when the
husband was going out to work at a factory. A few years
later she gave birth to a boy and after that she started to
have problems with her health. She was referred from
Anglicare to family support in 2001 as suspected of having a
mental illness. Recently, Mrs X often goes to Vietnamese
Women's Association (VWA) to get help because there she does
not face an English Language Barrier.
Epilepsy and mental
health problems
From the beginning, we found
out that Mrs X was admitted into Liverpool hospital a few
times because she had fits on the street. The Hospital had
sent a letter to refer her to see a neurologist for an
epileptic test, but her husband did not want to take her
there as he believed that the medication did not work and an
evil sprit got into her body. As a result, instead of taking
the right medication, Mrs X had only taken sleeping pills
that made her condition worse.
We tried to convince her
husband to allow her to have a blood test. Mrs X was
eventually diagnosed as having epilepsy that caused her to
have a fit almost every day. Mrs X has got a pension benefit
and her husband has got a carer's allowance to take care of
her. However, Mrs X sometimes does not have tablet and has a
fit again and her husband and his family and Mrs X herself
still thinks that an evil spirit got into her body that
makes her have mental health problems.
Domestic violence and
social isolation
Mrs X went to VWA and said
that she had suffered from domestic violence. Her husband
verbally abused her and sometimes hits her. The sister in
law abuses her and wants to sent her back to Vietnam because
of her mental health situation. Mrs X was assisted to get an
AVO at Liverpool Court.
We also learnt that Mrs X
was very isolated and has low self-esteem. Due to her
condition, she was rejected by her community. The neighbours
in her block of flats don't want any contact with her, the
children in her building are not allowed to go to her unit
or play with her son. Some shopkeepers around Cabramatta
have stopped her from entering their shops. Mrs X now always
feels sad, lonely and shamed because of her sickness. She
prays to the Buddha to help her get away from the evil. She
attended the Mental Health Wellbeing Group of the VWA twice.
If someone contacts Mrs X and tells her that she does not
suffer from mental illness and she only suffers from
epilepsy, she is very upset.
Interventions
Family support:
Counselling practice; childcare information; report to DOCS
about the child situation; playgroup for the little boy;
parenting group for the couple; information about AVO and
assistance at Liverpool Court.
Disability support:
Information about epilepsy and mental illness; Mental Health
Wellbeing Group at VWA; applying for accommodation from the
Housing Department; Financial support: food vouchers,
electricity vouchers; contacting Centrelink for pensioner
benefit and carer payment; providing transport to go to
Liverpool Hospital, Fairfield Community Health Centre;
Liverpool Court and Fairfield Department of
Housing.
Domestic violence:
This is especially very isolating when women have immigrated
and have no family or other support. Going to a women's
refuge is very difficult when the husband is the primary
carer of a child with disability.
Assessment
- Mrs X was upset that she
didn't have a mental illness because epilepsy is seen as
a mental illness in Vietnam, and in Australia it is not
assessed as a mental illness. Workers need to clearly
understand what clients believe is a disability, mental
illness, or evil spirit.
Service
access
- It is important for all
family support workers to work together. One problem is
that the family support workers are often part-time. The
stigma of mental health is a major barrier for people
using support services.
- Trish Franlin,
(Coordinator of a Centre for homeless children and
disabled children in Vietnam) went to Vietnam for two
years to work with people with disability. There are
currently very little services available. Because of
this, Vietnamese families trust government and Buddhist
services, but are confused about costs and requirements
to access non-government organisations.
- In Vietnam, hospitals
often deal with depression and other mental health
illnesses. In Australia, it is difficult for some people
to understand that there are community based services
available.
- Practical ways of
working with Vietnamese people with disability and their
families include: empathy; information provision;
transport; social support.
- VWA has limited funding,
and is often compared with better-resourced
non-government services and DoCS. Clients are comfortable
using other services, and families find it very important
to have access to a range of resources.
Appendices
- Summary of Workshop
Evaluations
- Workshop Participant
List
- Workshop Presenter and
Organiser Contact List
- Vietnamese Community and
Media Contact List
- Factsheet for Disability
Organisations
Appendix 1. Summary of
Workshop Evaluations
Pre-Workshop
Questionnaire Re: Expectations &
Knowledge
1. What motivated you to
attend the workshops?
- I work in SW Sydney
where there is a large Vietnamese Community. I do not
feel that I am serving their needs, or that they are
aware and confident to contact my
service.
- Working in
Parramatta, we service clients from a variety of NESB
including Vietnamese.
- To gain further
knowledge on cultural differences and needs to best meet
their needs appropriately/sensitively.
- I work with a couple
of Vietnamese families and realise that I have not got
the cultural knowledge to work
effectively.
- Have recently started
working at MDAA as individual advocate - am keen to
increase knowledge of different cultures and their
specific needs.
- To learn more about
the Vietnamese community and how to make our service more
accessible.
- It fitted my diary
and training requirements. Interest in Vietnamese
community.
- Want to find out more
about different ethnic communities and their views on
disability.
- Wish to establish
contacts and working relationship with people in
Vietnamese community.
2. Do you have specific
information needs related to the topic of encouraging
service accessibility that you would like addressed in the
workshops? What are they?
- Cultural variations
re attitude to disability, social interaction, use of
interpreters.
- Information on
specialist services/supports for people from Vietnamese
backgrounds.
- Understanding of what
disability services are available in their homeland - how
they operate/run.
- Who has access and
what models of Early Intervention are
practised.
- Perception of
disability.
- Perception of
disability services.
- How are disabilities
perceived in Vietnamese community.
- Suggestions for how
best to target community to inform of our
service.
- Understanding
decision-making structures in Vietnamese community.
Vietnamese persons relationships with Government/legal
options.
- What is the best way
to let the Vietnamese community know about our service.
If they knew about our service would they find it
beneficial to use it.
- How to make a
government tribunal more accessible to people from
Vietnamese background.
3. Could you identify
what you know about the needs of people from a Vietnamese
background who have a disability?
- Limited contact but I
would presume that they would vary from individual to
individual.
- Communication/cultural
support.
- Early identification
and intervention.
- Access/knowledge of
available services.
- Not
much.
- They may have
difficulty accessing services due to lack of culturally
appropriate materials.
- Their need to be told
about the disability in their first language. The
implications of the disability and how it affects the
child's developmental potential.
- No specific knowledge
in the area.
- What they need from
services to help them access different services more
fully.
- Need for services
that are in short supply.
- Not aware of any
cultural specific services.
4. Could you provide an
estimate of the percentage of people from a Vietnamese
background using your service?
- 3%
- Not
sure.
- Approximately
20%.
- 5%
- Will provide details
at later date.
- 10%
- Too difficult to
access data.
- At a rough guess very
very few.
- Less than
1%
5. If there are barriers
for Vietnamese people in accessing your service, what do you
think these barriers are?
- Lack of awareness
- their needs - what is on offer.
- ours - how best to service population
- ours - lack of promotion of service especially to
different cultural groups.
- Language barriers
(numerous)
- Understanding the
system - processes.
- Language.
- Services available -
where? How to refer/access.
- Language, culture,
lack of knowledge of services, how western style
bureaucracies work.
- Knowing that the
service exists.
- Feeling comfortable
approaching service - worrying re cultural
appropriateness, knowledge.
- The child must be
attending childcare.
- The parents have to
accept that the child has a disability.
- The language and
cultural barriers.
- Language and
awareness.
- Lack of knowledge
about the service lack of transport to get to the service
need for interpreters.
- Lack of awareness of
Tribunal.
- Concern about
government 'taking over' family
responsibilities.
6. What links, if any,
does your service have with Vietnamese specific service
organisations?
- None, that I am aware
of (x5)
- E.C.I.C.P.
- Family and Children's
Services - Liverpool - Network meetings.
- SUPS and Ethnic
Workers Pool through local Council.
- Vietnamese Women's
Association.
- None. Would like to
establish some.
Workshop 1
Evaluations
What did you find useful
about the workshops?
- Having real life
stories, first hand experience, not
theoretical.
- Human drama - Tam
Nguyen's story.
- Personal
stories.
- Informative
(information given by people who have experience the
culture/cultural differences between Vietnam and
Australia).
- Participants
(speakers) very willing to share and answer
questions.
- Good start towards
learning more about Vietnamese culture and how to serve
that client group.
- Finding out what was
culturally acceptable/not acceptable in order to make
access of services appropriate.
- Individual
perspectives of the speakers, particularly in adapting to
the Australian community. Helped to explain dilemmas in
service delivery ways to provide service in a more
useable way.
- Understanding the
finer points.
- Realising there are
more differences than initially thought.
- General historical
overview good - one would like to think that people had
some awareness.
- Practical day to day
(session) great.
- General discussion
from all Vietnamese workers present was very informative
casual and anecdotal.
- Some insight into
cultural move of Vietnamese people and perhaps why we
have no Vietnamese clients in our
service.
- Understanding the
culture.
- Understanding the
refugee experience.
- The last
speaker.
- Culture.
- Communication/cultural
approaches.
- 1.5 hours is too long
to wait before a break. I need to stretch my legs after 1
hr and 10 minutes at the most.
- Guest speakers'
personal experience was fascinating.
- The workshop helps me
to know how the Australian or other workers think about
Vietnamese culture.
- The information
especially the sections regarding interpersonal exchanges
and barriers.
- The speakers sharing
their personal experiences.
- Everything.
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