The Vietnamese Community in South West Sydney
- Workshop Report, April 2003

Our Resources > Ethnicity and Disability > Specific Communities > VIETNAMESE

Foreword

Executive Summary

Workshop 1 - The Vietnamese Community

Workshop 2 - Different Service Systems

Workshop 3 - Disability and Health

Appendices

1. Summary of Workshop Evaluations
2. Workshop Participant List
3. Workshop Presenter and Organiser Contact List
4. Vietnamese Community and Media Contact List
5. 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

1. Summary of Workshop Evaluations
2. Workshop Participant List
3. Workshop Presenter and Organiser Contact List
4. Vietnamese Community and Media Contact List
5. 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.
• Informative re cultural differences and relating this to my experience with families. Each speaker added a personal touch/experience which was great. Overheads and handouts were helpful for adding to my own notes.
• Learning about the culture, the family system, and the struggles that most seem to have been through.
• Different ways of approaching different cultures.
• Cultural awareness and how to work with two cultures and how strong the culture is.
• Speakers use of personal experience. Their thorough knowledge of topics.
• Definitely the cultural practices and beliefs, very informative and highly useful.
• Personal stories.
• Being able to ask questions and have genuine, personal opinions given.
• Insight into Vietnamese culture by Vietnamese guest speakers.
• Information from people who have personally experienced migrating etc.
• It opened by eyes to the cultural variations and gave me much to think about. But also useful ideas on how to move forward from here.
• Communicating techniques such as greetings and saying "yes" at first to the questions.

What issues/topics would you recommend for future workshops similar to this, involving a specific community

• More of the same.
• How to work with families with disabilities especially when not accepted, and the family values are so strong.
• Handouts of relevant statistics.
• Similar issues - whatever is pertinent to their culture (things workers really need to consider so as to provide a useful and helpful service with respect to cultural differences).
• Looking at demographics/statistics and then more courses liked in to other cultural groups, e.g. if high proportion of Arabic then course on this.
• The conflicts facing communities as the younger generation are exposed to different cultural beliefs and attitudes.
• Would like one as Arabic and Islander groups.
• Ways to facilitate service access.
• Assyrian.
• Cultural studies.
• Support services.
• Values, Disability, Gender, Sexuality.
• It appeared to be fairly comprehensive.
• Possibly we could bring a question and have it answered or discussed.
• Arabic Community - some issues/topics.
• Maybe more time for "dilemma" being able to ask for ideas or advice on specific situations.
• Service provision how to better it.
• I think that this would be useful to a wide variety of cultural groups that we may not be assisting fully.
• Perhaps a workshop on Vietnamese culture and domestic violence - could target woman's refuge movement.
• Also more disability and cultural issues workshops.

What type of further assistance would you require?

• Possibly more focused on just our organisation's role rather than general.
• Would be really helpful to have a visitor to our team to discuss current practice and service delivery - make it more inclusive.
• Opportunities to discuss service with Vietnamese community groups - translated on their terms, their preferred environment - further acceptance into the groups - not seen as the authority.
• Service access.
• How to access Vietnamese services to encourage referrals from that community.
• Workshops specifically identifying goals, targets and strategies to employ as a service.
• To organise support groups.
• Introduce our service to the community.
• Service promotion and awareness.
• In the process of starting a new project.
• To assist in workshops for Vietnamese speaking families, to assist in planning accessing a new service if required and to use as a resource if having difficulty with a client.
• Whether the Vietnamese community would want assistance from our organisation. What would be the best way of providing it?
• For the worker to know more of the services around so we can introduce to the family that we come to service as we could not know they have family member with disability.
• Detailed advice about how to first approach the community - key contacts.
• What methods of information provision are most effective (e.g. written/radio/talks etc).
• Possibly some assistance in approaching our Vietnamese speaking families to involve them more actively in our service provision.
• No, but will definitely call for assistance rather than flounder.
• How to provide a cultural appropriate service to Vietnamese clients.
• Our service is offered on a "you ask" basis. Families ring a central referral phone number to ask for a particular service. This may not be the best method of access for Vietnamese families.
• I would like to hear more but probably in developing the trust and relationship as mentioned today. Also ensuring that the service is appropriate to those receiving it.
• Ongoing support to check/confirm new programs etc.

Workshop 2 Evaluations

• What did you find useful about the workshops?
• Ways of accessing and getting my service known in the Vietnamese community.
• The importance of building trust and offering a service in a clear way, being patient and persistent.
• Information of the Vietnamese experience and perspective is both valuable for service direction, as well as being very interesting.
• The discussion session.
• Discussion was very good. A useful change. Interesting and informative.
• Group discussion - asking questions.
• Useful information about lack of service systems in Vietnam. Interaction in second part when we could ask questions - open discussion. It is starting to make sense knowing the background information of refugee Vietnamese and relating it to how we can provide/make accessible our service.
• The whole Vietnamese experience - the journey from Vietnam to arrival in Australia. The group was very informative.
• Little bits of information or ideas that you pick up eg. radio.
• Again personal rather than theoretical knowledge. Openness of speakers in sharing knowledge.
• The thought of using Vietnamese GPs to disseminate information.
• To understand that even with Vietnamese, we still find very difficult to get out what they want.
• Very useful in understanding Vietnamese health system and how to deliver service to Vietnamese people in Australia.
• Speaker - from Council - articulate and good to hear insight about generation gap.
• I gained a greater understanding of Vietnamese people's cultural experience.
• I found the real experiences to be useful, as it gives you an insight to families and their culture.
• To get to know more about the services available and how to get people to approach.
• Information on leaving Vietnam/life in Vietnam now.
• Councillor - Thang presenting an Australian/Vietnamese approach - very thought provoking. Thank them for their honest contribution.
• Further insights into family culture as impact on available services.
• The discussion re service access/provision to the Vietnamese communities. Contacts. Issues. Resources.
• Excellent discussion session. Personal stories add to understanding.
• There was repetition of the concepts of no social infrastructure - impact on interaction with services here. Again really appreciated other speakers from community. Although not really relevant to my service I thought the advice re. Using medical, GP groups etc for further info, etc.
• Have Thang's experience as a leader.
• The variety of speakers and their knowledge of the Vietnamese community.
• Gaining more insight into the community in general.
• The accounts of personal experiences, anecdotal information and insights from individual perspective.
• Good ideas generated in terms of how to access Vietnamese community so they know services exist.

Workshop 3 Evaluations

What did you find useful about the workshops?

• The first speaker's comments about attitudes.
• 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.
• All speakers were very interesting and gave an insight into Vietnamese culture.
• Surprising statistics about mental health issues in Vietnamese community.
• Chance to come up with some concrete ideas/steps to take next.
• The various kinds of stigma and how to overcome them.
• The input from different people/perspectives.
• All of it.
• Finding out more about cultural diversity and the Vietnamese community.
• General awareness of diversity and how we as community workers must be aware of all these needs when dealing with people.
• Understanding of constraints of Vietnamese community to using 'regular' services.
• Understanding of 'disability' for Vietnamese families.
• A wide range of speakers with all different perspectives.
• Cultural information.
• Service input.
• Insight and ways to offer our services to the Vietnamese community.
• Thanks you for all the speakers who shared their stories and lives with us.
• Contacts, cultural issues, resources.
• It opened up my eyes to Vietnamese cultural practices and beliefs.
• Personal stories.
• Development of strategies.
• Cultural information to assist in working with Vietnamese people with a disability.
• Information on cultural beliefs, values and perceptions on disabilities.
• Personal stories/accounts on disabilities within family.
• Able to receive information about how Vietnamese regard disability.
• Starting to plan how Vietnamese people can access our services (concrete tasks to follow up).
• Listening to story of Vietnamese father.
• Learning about beliefs regarding disability.

What issues/topics would you recommend for future workshops similar to this, involving a specific community?

• Bosnian, Lebanese, Islander.
• How to make your service accessible to people with disabilities.
• The case study was good.
• Other cultures - Chinese, Arabic, Spanish, etc
• Unsure.
• Working with families.
• I think that most topics were adequately covered.
• Similar lines - whatever is pertinent to that specific cultural.
• Good to follow similar topics e.g. access, beliefs, cultural.
• Working with Arabic community/family re disability issues.

What type of further assistance would you require?

• Contact numbers for major Vietnamese services and community leaders.
• Covered in "Concrete tasks to follow up".
• Most relevant way to provide information / relevance of support groups.
• Translation of brochure, information about our services.
• Contacts.
• Guidelines of best practice.
• Contact list of Vietnamese organisations.
• Communication and contacts in the community.
• Contacts within Vietnamese community/organisations for referrals.
• More information on working with people from Vietnamese communities long term (language barrier).
• As discussed in follow-up tasks.
• As I have made contact with Vietnamese Workers that I can call.
• To provide joint projects to Vietnamese community workers.
• Involvement in group effort to increase awareness.
• Yes for a new or specific project, assistance with introduction to Vietnamese community.

Additional comments

I have thoroughly enjoyed these workshops - the variety of speakers, their own stories but also their professionalism. I come from a different perspective as the client is already in our service - we are not seeking people to access the service - but was still relevant and very useful! I also like the 3 sessions spread over 6 weeks - easier on a part time workload.

Appendix 2. Workshop Participant List

• Kathy Thurgood - Active Employment
• Sharon Castellino - Active Employment
• Joanne Barbara - Aftercare Paterson Whitlam Support
• Kerry Spindler - Aftercare Paterson Whitlam Support
• Maija Ringis - Brain Injury Association of NSW Inc
• Anne Casey - Centacare
• Cynthy Iniguez - Centacare
• Lyn Dufficy - Centacare
• Samantha Fields - Centacare
• Deb Hughes - Children's Hospital at Westmead
• Kerry Moran - Department of Education & Training
• Steve Norris - Disability Services Australia
• Mai Duong - Ethnic Obstetric Liaison Service
• Nguyet Cao - Ethnic Obstetric Liaison Service
• Yu-Lee Yong - Fairfield Hospital
• Maria Renzi - Fairfield Resource & Support Team (Fairfield City Council)
• Truong Colam - Fairfield Resource & Support Team (Fairfield City Council)
• Marian Brown - Guardian Tribunal
• Peter Heffernan - Guardianship Tribunal
• Jackie Klarkowski - Guardian Tribunal, Training and Development
• Sue Young - Guardian Tribunal, Training and Development
• Carol Grayson - Guide Dog Association of NSW
• Jane Bryce - Guide Dog Association of NSW
• Judy Williamson - IDRS
• Sue Slattery - Independent Living Centre of NSW
• Jane Scardoni - JobMatch
• Nicole Nevin - JobMatch
• Angela Wilson - Macarthur Disability Service Limited
• Elizabeth Martin - MDAA
• Melanie White - Miller Community Preschool and Early Intervention Service
• Anita Fisher - Northcott Society
• Gail Saunders - Northcott Society
• Rosemary Thomas - Northcott Society
• Chris Hankinson - South West Early Childhood Support Services
• Dympna McLaughlin - The Spastic Centre
• Elain Stovin-Bradford - The Spastic Centre
• Jenny Roncome - The Spastic Centre
• Liz Hopkins - The Spastic Centre
• Rachel Wootton - The Spastic Centre

Appendix 3. Workshop Presenter and Organiser Contact List

Presenters

• Anh Le - Bilingual Mental Health Worker
  Fairfield Community Health Centre Telephone - 9794 1720
• Tam Nguyen - Bilingual Mental Health Worker
  Fairfield Community Health Service Telephone - 9794 1700
• Alice Thai * - Ethnic Health Worker
  Corner Youth Health Service, Bankstown Community Health Centre Telephone - 9796 8633
  * Contact Alice for a copy of the Vietnamese Workers contact list in Sydney
• Thang Ngo - Councillor
  Fairfield City Council Telephone - 9725 0222
• Hien Le - Coordinator
  Vietnamese Women's Association Telephone - 9723 2022
• Kim Huynh - Disability Support Worker
  Vietnamese Women's Association Telephone - 9723 2022

Workshop Organisers

Vietnamese Women's Association in NSW

Hien Le, Coordinator and Kim Huynh, Disability Support Worker
Cnr Railway Parade and McBurney Road, Cabramatta NSW 2166
Phone 9723 2022 Fax 9723 3033 Email vwa_nsw@bigpond.com.au

The Spastic Centre

Robyn Cummins, Information Manager, Paul Mavromatis, Community Development Manager and Penny Baldwin, Regional Manager
189 Allambie Road, Allambie Heights NSW 2100
Phone 9451 9022 Fax 9451 4877
Email rcummins@tscnsw.org.au
Website www.thespasticcentre.org.au

Multicultural Disability Advocacy Association of NSW

Barbel Winter, Executive Director
40 Albion Street, Harris Park NSW 2150
Phone 9891 6400 Fax 9635 5355
Email mdaa@mdaa.org.au
Website www.mdaa.org.au

ACROD NSW - National Industry Association for Disability Services

Gabrielle Jones, Network Development Officer
Suite 103, Level 1, 1-5 Commercial Road, Kingsgrove NSW 2208
Phone 9554 3666 Fax 9554 3188
Email acrodnsw@acrodnsw.net
Website www.acrodnsw.net

Appendix 4. Vietnamese Community and Media Contact List

Associations

Australian Vietnamese Professional's Association (AVHPA) NSW Inc
PO Box 782 BANKSTOWN NSW 2200
Website www.vnr.faithweb.com
Email lieuvinbinh@yahoo.com.au
Weblink www.medlife.faithweb.com

Vietnamese Community Association (NSW)
Bankstown - Phone 9796 8035, Fax 9796 3794 or
Cabramatta - Phone 9727 5599, Fax 9796 5276

Vietnamese Women's Association
Cnr Railway Parade and McBurney Road, Cabramatta NSW 2166
Phone 9723 2022 Fax 9723 3033
Email vwa_nsw@bigpond.com.au

Media

2VNR - Vietnamese Radio
Contact Don Nguyen, Ph: 9637 5228 Fax: 9637 1251
4 weeks 3spts/day = 72 spots + 5 Bonus spots.
Cost: $1188 + $220 (production) = $1408

SBS Radio
Contacts Robert Gale, Ph: 9430 2817 or Peter Nhuan, Ph: 9430 2837, Artarmon.
Total of 42 paid spots @ $55 per 30 sec spot. Total of 12 bonus spots, no charge. Cost: $2310 (for 54 spots) + $490 (production) + GST = $3080

Chieu Duong (Sunrise Daily Newspaper)
Contact David Giang or Alice. Ph: 9725 6444, Cabramatta
E-mail chieuduong@optusnet.com.au
Cost $330 (10cm X 10xm) x 3 spots = $990

Vietnam Thoi Nay (Vietnam News Today)
Contact Viet Media Group - Monica Vu, Ph: 9600 6846, Bankstown.

Viet Luan - Vietnamese Herald
Contact Thuy Bui, Ph: 9796 3922, Bankstown
E-mail thuybui@vietluan.com.au
Cost $80 for ¼ pg (B/W) x 8 spots = $640 + GST = $704

Phu Nu Dep (Vietnamese Beauty)
Contact Hilary Nguyen. Ph: 9728 4020, Liverpool
E-mail pnd@hotmail.com

Saigon Times
Contact Tony, Ph: 9785 8431, Bankstown
E-mail levanchris@netscape.net

Dan Viet
Contact Gia Du, Ph: 9892 4441, Fairfield
E-mail giadu@auco.net.au

Liverpool, Fairfield, Bankstown Community Newspapers
Contact Frank Sciciuna Ph: 9602 8633
Cost: for 3 papers & 4 appearances each = $3556.80

Macarthur Community Radio
Ph: 4625 2768. Cost: 357.50 for 40 spots
Provides free announcements for community services.

To preserve authenticity,
the information in this report is published as it was presented at the workshops.

The report is available to download free of charge from the websites of

The Spastic Centre www.thespasticcentre.org.au
ACROD NSW www.acrodnsw.net
and the Multicultural Disability Advocacy Association www.mdaa.org.au

To order a hard copy, please telephone Michele Linney on 02 9451 9022
or email scnsw@tscnsw.org.au

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