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Page 14 Notes Introduction: Sudden Unexpected Nocturnal Death Syndrome  ~100 southeast Asians in the United States have died from the mysterious disorder that is now known as SUNDS (Sudden Unexpected Nocturnal Death Syndrome).  High incidence among Loatians (particularly male Hmong refugees). At its peak, the rate of death was 92 per 100 000l; equivalent to the sum of the rates of the five leading causes of natural death among United States males.  Despite numerous studies of SUNDs, medical scientists have not been able to determine exactly what is causing the deaths of these healthy people in their sleep. The Nightmare  Argument: Biomedicine cannot explain for the cause of SUNDs but the author proposes that an investigation of Hmong TRADITIONAL BELIEFS can reveal the event that triggers the fatal syndrome.  When author used the word ‘nightmare’ she does not use it in the modern sense of a bad dream but as the nocturnal visit of an evil being  According to descriptions of the nightmare spirit, the sleeper suddenly becomes aware of a presence close at hand, becomes completely paralyzed, exerts pressure on sleepers chest to interfere with respiration  This study is an exploration of the role of powerful traditional beliefs in illness causation The Hmong  The Hmong are a partly Sinicized, semi-migratory people , who in recent centuries have inhabited the higher altitudes of southern China. For thousands of years the Hmong lived in China as nomads and mountain people, but in the middle of the nineteenth century thousands began fleeing to Laos and other Southeast Asian countries to escape the harsh rule of the Manchu dynasty.  In the West, Hmong are known than other Laotian ethnic group because of their involvement during the war in Viet Nam.  Many Hmong died from hunger, disease, and drowning to reach asylum in the refugee camps of Thailand and those who reached the camp had to endure many hardships  More than 100, 000 Hmong escaped directly to France or America. Ethnomedical Pathogenis  Hmong have undergone transitions involving religious belief and health practices (From Laos to America)  One of the myriad differences between traditional Hmong conceptualizations of illness and the Western biomedical conceptualizations of disease is that in the traditional Hmong worldview the functions of the “mind” and the “body” are not dichotomized and polarized.  The biomedical paradigm obscures the role of such “nonscientific” factors as traditional beliefs in affecting health and illness Previous Findings  Prior investigations of SUNDS fall into three categories: biomedical, somnologic
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