Hmong refugees: From secret war to hidden struggles

During the Vietnam War, the CIA wanted to quietly contain communism in neighboring countries, which led to what became known as the “Secret War” in Laos.

This meant Laos was neutral in name but war-torn in practice. In an attempt to crush North Vietnamese supply routes that ran through Laos, the CIA recruited Hmong men to fight and dropped bombs – 270 million of them – on Laos for almost ten years. When the communists eventually gained power, thousands of Hmong fled. Fifty thousand came to Wisconsin and 4,000 settled in Madison.

While they escaped the bombs, many refugees still struggle with the lasting effects of PTSD and trauma.

A traditional Hmong house adjacent to Kajsiab House, a community center that focuses on mental health treatment for Hmong individuals. (Lisa Speckhard/Madison Commons)

Traumatic experiences do not destine refugees – or anyone else – to a life of mental illness or PTSD. In fact, 80 percent of trauma survivors show positive psychological symptoms, like sympathy and empathy towards others who experience hardship, said Aydin Bal, assistant professor of rehabilitation psychology and special education at University of Wisconsin-Madison. But when the traumatized don’t receive proper psychological support, Bal said, or are placed in negative climates with racism or without equal opportunity, it’s more likely that they will start to show PTSD symptoms.

Following the Secret War, many Hmong refugees ended up in communities that were ill-equipped to address their needs. Most Hmong couldn’t drive or speak English and therefore couldn’t access or benefit from any available services.

There also existed and still exists a significant stigma about mental health care in the Hmong community, according to the State of the Hmong American Community 2013 Report. Without a history of mental health care in their native country, a diagnosis of mental health issues was often perceived as an insult to intelligence and sanity. Logistical and social barriers made receiving mental health care difficult, leaving many Hmong with another hidden war to fight.

For some Hmong in Madison, the key to winning might be bingo.

Bingo is one of the many services offered at the Kajsiab House, a community-based group focused on the mental health of the Hmong population. The game is just as inexplicably popular as it is in any American nursing home, but here the numbers and letters are called out in Hmong.

Bingo may seem unrelated to mental well being, but every piece of the Kajsiab House’s program is important. Each program aims to dismantle barriers that keep people from seeking mental health support.

The Kajsiab House started by focusing on logistical barriers and provided Hmong-speaking staff and transportation to and from the center. They then turned to the cultural stigma. Bingo was one such service that could attract individuals to the center.

These wrap-around supportive services, as Program Manager Doua Vang calls them, make the program welcoming to the Hmong and a desirable place for forming community.

”We do counseling, case management, wrap-around supportive services, that include assisting clients with their Social /security, INS, food share, food stamps, W2s, pretty much anything that can alleviate their stress to make them feel more comfortable and more adjusted to the community,” Vang said, and noted that it is important that these services include a core cultural focus that acts as a powerful draw to overcome stigma.

Once there, they can choose to receive mental health counselling from the Hmong-speaking clinicians, psychiatrists, psychologists and therapists. This structure – the professional mental health staff, the variety of services and the focus on the Hmong community – is what makes this organization the only one of its kind in the nation.

On the walls are pictures with small descriptions, created by clients in art therapy sessions, that oscillate between the grateful “I am happy that I am here at Kajsaib House,” to the heart-wrenching “I look everywhere for my daughter but I cannot find her.”

This side-by-side display of hurt and hope is reflected in the wider Hmong community as well. The Hmong community in America has typically struggled with poverty, academic achievement gaps and health disparities.

Hmong are one of the poorest ethnic groups in America, with a poverty rate twice as high as the national average, according to the 2010 US Census Report. This is partially due to language barriers, lack of education and past traumatic experiences that prevent them from learning and maintaining employment, Vang said.

Language barriers also affect academic performance, as parents are often unable to help children with schoolwork, and Hmong children are too often placed in English Language Learner tracks. In 2013, Dane County data showed that 87 percent of Hmong children could not read at grade level.

Hmong parents teach their children to be disciplined in school, but this has the adverse effect of making them invisible in the classroom, said Mai Zong Vue, intercultural program coordinator in the division of mental health and abuse services for the Wisconsin Department of Health.

Statistically, things have improved for the Hmong in the US over the last 20 years. Poverty rates have decreased from 64 to 25 percent, while the ability speak English “very well” has more than doubled. Significantly more Hmong adults are now graduating from college as well.

Vue said for things to keep improving for the Hmong population, individuals need to be economically, educationally and socially integrated into their surrounding communities.

It’s important to provide Hmong populations with a safe place to form community bonds, Vue said. “If they don’t know who they are, don’t understand their strengths and understand their challenges, they won’t be successful in integration.”

The Kasjaib House provides just such an environment and has seen encouraging results.  

“History itself has shown that people who are getting treatment are doing gradually better than people who are not getting the services,” Vang said.

A version of this story was fist published on The Arc. The website is the result of a collective effort to examine justice in Madison by students in a reporting course at the University of Wisconsin-Madison taught by Professor Michael Wagner.