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KAREN COMMUNITY
Note: Not all the template categories may be covered in this profile by the community
writer—some categories may not have been relevant to this culture.
INTRODUCTION
• The Karen-Burmese live in mountainous jungle regions of southern and eastern
Myanmar, and Thailand. Myanmar is located in South-East Asia, formally known
as Burma. It is a developing country and largely rural. It shares borders with
China, Tibet, Laos, Thailand, Bangladesh and India. It has population of
50,519,000. Life expectancy is 61 years.
• In Karen culture, older people are considered seniors. Age is considered the most
important, no matter the ranks or educational backgrounds. The oldest person or
older people are expected to be treated with care, kindness, and respect.
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HISTORICAL BACKGROUND
• 1886 Burma became a province of British India. In 1948 it gained independence
from British rule. In 1962 a military dictatorship took power, which caused a large
out flow of refugees. In 1988 martial law was declared which resulted in increase
of refugees.
• In Burma the largest indigenous population are Karen. Other indigenous races
include Shans, Chins, Mon, Rakhine and Ktchi. There are always tensions
between Burmese majority and other minority ethnic groups.
• We do not refer to the Karen people as Burmese. Ethnically, they are a
completely different group and many will not even speak Burmese. The Karen
were exiled from the country of Burma. They were driven out by the Burmese. So
many Karen people will not identify with the Burmese in a very positive way.
• The political stance of the Karen will vary with their experience, but still, unless
the person corrects you, it is much better to refer to people by their ethnic group
(Karen, Chin, Kachin, Shan, Karenni) rather than call them Burmese. (The Karen
Konnection, 2007)
• Karen people have been in state of civil war for much of the past 50 years.
• There are two main groups of Karen, the Pwo and the Saga. The groups can
further be categorized, depending on the regions they live in Burma. Karens from
Myanmar, formerly known as Burma, are one of the eight major ethnic groups.
The Karen state is under the administration of the Burmese military junta. The
State Peace and Development Council, is situated in the eastern part of Burma,
bordering Thailand.
• The Karen people in hilly eastern areas of Burma are mostly internally displaced
and currently live as refugees in camps on the Thai-Burma border. This is due to
the country’s internal armed conflicts and fighting between troops loyal to the
Burmese military junta and those to the armed Karen freedom fighters, who are
also known as the Karen National Liberation Army under the political leadership
of the Karen Nation Union.
• The refugees living in the border region are not allowed out of the refugee camps
and cannot work. However, refugees serve on camp committees, which are the
administrative and management bodies of the camps. They coordinate the day-to-
day running of the camp and its services in collaboration with local officials, and
provide the main link between the camp population, NGOs, UNHCR and local
Thai authorities.
LANGUAGE AND COMMUNICATION
Languages spoken, written and alphabet used
• The languages spoken are from Tibeto-Burmese family. There are 12 different
dialects, and over 80 per cent of the people speak either Saga or Pwo. The
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language which was written in ancient Karen script is known as “chicken scratch”,
which is not used any more.
• Saga and Pwo langauges are in some cases totally different. Very few Karen
people from the hilly eastern part of Burma speak and understand Burmese.
• Most Karen speak both Pwo and Saga languages. Only Karen people who were
educated in Burmese can speak and write Burmese well. Those who were born in
the remote areas of Burma and in refugee camps and on Thai-Burmese border do
not communicate well in Burmese. They might not be able to write Burmese
although they may understand some Burmese. The majority of them do not
communicate in Burmese.
Communication styles
• It is not a polite form of communication to look a Karen in the eyes while talking
to them, especially in the case of a man and a woman.
• Normally, a young Karen would not call an older person by their name. They have
special words of respect for them. The older person regardless of any blood
relations would be addressed as “Uncle” or “Untie.” For example if the older
person’s name is Wah Bu a younger person would call him Tee Wah Bu meaning
Uncle Wah Bu.
• Karen people normally would not say much in the presence of elderly people.
The younger Karen especially would hold on to their thoughts in front of the older
people as a sign of respect and also as an indication of acknowledgement of the
knowledge and experience of the seniors. It would not necessarily mean that they
are not interested or they are lazy and don’t want to do anything.
• When dealing with the Karen people, it is important to keep in mind that the
Karen usually would not express their ideas openly, especially in public or in a
meeting. It is important to develop a relationship and build trust before they talk
to you about their personal thoughts or ideas and seek help.
Greetings
• There are many different ways of greeting in this community:
1. Holding your right elbow in your left hand, and using your right hand to
shake hands. Karen people might use both hands to shake other people’s
hands, meaning more respect/ kindness.
2. “Where are you going?” can be a greeting in the Karen coomunity.
3. Smiling at someone can be another form of greeting, when there is nothing
to say.
4. Karen people greet three times, “Good morning/ afternoon/evening”.
EDUCATION
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• Education is highly respected in Karen culture. Children go to school from age
five to 20 years old, although some children do not start school until 10 years of
age. Kindergarten is two to three years.
• During adolescence, some children must stay at home to take care of their
younger siblings to allow their parents to work in the field. Sometimes the
teenagers must work in the fields with their parents. Schooling can get disrupted
when armies invade villages and the people must flee for safety.
• There are no ceremonies to mark birthdays or rites of passage into adulthood.
Adulthood is considered to begin around the age of 20 when people marry. All
the children are responsible for their elderly parents in their old age.
Seniors’ attitudes towards education
• Karen people value education, but the degree of value may differ depending on their
own and other’s level of educational background and experiences.
• It is normal for seniors in the community to encourage young people to study and
get an education. Back home, seniors are hardly seen as students in schools. They
are either the teachers or someone who plays other roles other than that of a
student.
• In Karen culture, seniors are considered persons with wisdom, knowledge, life
experiences, regardless of their educated. If these seniors are offered a chance to
go to school, they would say they are too old.
How seniors view professionals
• Elders are respected as well as teachers, pastors, priests and those who are
educated. In the villages an elder may know traditional medicine. Many Karen
have a culture of not imposing views on others or being quiet or less talkative.
• Doctors have high social status so seniors may not be comfortable questioning
them or expressing dissatisfaction with their treatment.
• Health care providers should ask open-ended questions and allow opportunity for
Karen patients to follow up with additional questions about their healthcare at a
later time. Generally, patients consult with members of their own community
about healthcare-related matters and then will have more information to follow-up
with their doctor again.
• Professionals are highly regarded in this community. Although, the Karen would
normally trust a family member instead of the professionals, but once they gain
trust in a professionals they will often ask them to help them in making decisions.
• Professionals will be welcome as long as they treat community members with
respect, are humble and have sincere kindness and understanding of others’
problems.
Notes
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• Karen people do not easily trust other people from other races, especially in
Burma given the history of conflict with the Burmese successive governments,
political lies and broken promises. Burma troops in the war torn zones have
tortured, raped and carried out extrajudicial killings of Karen on a daily basis.
Therefore, based on those bitter experiences Karen do not trust people from the
Burmese community and from some other races readily.
RELIGION AND FAITH GROUPS
• Karens are either Buddhists or Christians. A few of them are animists.
Animists
• In anthropology, animism can be considered to be the original human religion,
being defined simply as belief in the existence of spiritual beings. It dates back to
the earliest humans and continues to exist today, making it the oldest form of
religious belief on Earth.
• It is characteristic of aboriginal and native cultures, yet it can be practiced by
anyone who believes in spirituality but does not proscribe to any specific
organized religion.
• The basis for animism is acknowledgment that there is a spiritual realm which
humans share in the universe. The concepts that humans possess souls and that
souls have life apart from human bodies before and after death are central to
animism, along with the ideas that animals, plants, and celestial bodies have
spirits.
• Traditional animist –worshipping belief systems:
1. Thermyngkae, is lord of land and water
2. There are local spirits, beneficial and malicious ghosts
3. People make sacrifices to natural forces
4. Often incorporated into understanding of organized
religion
Christian
• They make up 65 per cent of the population. They emphasis Bible study and
prayer services (hymn singing) Their skin is adorned with tattoos for magical
protection.
• Martyr day
• Fast for half to fullday
• Some do not drink tea or eat pork on day of worship (Saturday)
Buddhist (28 per cent)
• Considerable interplay with animist rituals/practices
• Often wear amulets
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• Do not drink alcohol
Muslim (11 per cent)
• Worship to Allah contributes to both spiritual and worldly well-being to:
• Enrich and develop the soul
• Prepare for the life to come
• Abstain from eating certain foods including, pork and its by-products
• Do not eat flesh of animals which have died without being ritually slaughtered
(Halal meat products are consumed)
Influence of religion on culture
• The Karen people may belong to different religions but their cultural expectations
are not so much different. For example, seniors are to be treated with respect by
any young person, no matter how rich or poor the senior is.
• Health is related to harmony in and between the body, mind, soul and universe.
Harmony expressed as a balance between ‘hot’ and ‘cold’ elements (not
necessarily related to temperature) States of health seen as ‘hot’ or ‘cold’ –
treatment with the opposite medicine or foods.
• Postpartum period is time of susceptibility to illness –mother’s body ‘cold’ from
blood loss. Body should be warmed with external heat and warm drinks as well as
foods with ‘hot’ properties. Sour and bitter foods are also believed to reduce
blood flow.
FOOD AND DIETARY GUIDELINES
• Good diet and lifestyle can support people to re-establish optimal physical health.
Maintenance of traditional diet and lifestyle is an important strategy in ensuring good
health in the long-term.
•
It can help to affirm culture and promote communication The Victorian.
The Karen
people are highly skilled farmers. Crops include rice, vegetables, corn, sesame and
chilies. It is not uncommon for neighbors to help one another farm. Planting tobacco
near rice fields keeps the insects away. Tobacco is used for this purpose as well as for
smoking. A “living fence” is used between fields to separate and maximize the space for
farming. Often times, families will raise livestock such as chickens, pigs and cows
• A typical Karen dish consists of rice with a variety of vegetables and meat on occasion.
Vegetables include cucumbers, squash, bamboo shoots, eggplants, mushrooms from the
forest and edible wild vegetables.
• If fishing is an option, they will include in their diet a very famous dish among the
Karen known as “nyau” or in Burmese “ngape”? A strong-tasting dish of fermented
fish pounded into a fish paste that is usually served with rice and vegetables to add
flavor.
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• Karen people often flavor their meals, such as curry dishes, with chilies and add spices
such as turmeric, ginger, cardamom, garlic, tamarind, and lime juice.
• There are many food taboos that exist in traditional Karen culture, especially with
regards to illness. For example, people who have hepatitis are told to avoid yellow
foods and papaya is thought to trigger malaria. It is important to address dietary
concerns with patients when an illness is diagnosed.
• A diet composed mostly of rice, salt, chilies, and some vegetables contributes to a lack
of protein and vitamin deficiencies. A clinical manifestation of vitamin deficiencies in
seniors is the appearance of lighter colored hair.
• Some senior females might have had Thiamine deficiency during pregnancy or as post-
partum lactating women, and as young children in the villages. The Karen seniors are
prone congestive heart failure due to Thiamine deficiency earlier in life.
• Seniors should be encouraged to consume more foods that contain vitamin B1. Such
foods include green peas, spinach, liver, beef, pork, navy beans, nuts, pinto beans,
bananas, soybeans, whole-grains, enriched cereals, breads, yeast, and legumes. Vitamin
B1 aids the body's metabolism of carbohydrates and fat to produce energy.
Concept of “hot and cold” food
• There are concepts of hot and cold, and if one is sick, it is good to have things that are
thought to make the body hot.
• Turmeric is used medicinally both internally and on the skin. There are many food
taboos (e.g. if you eat papaya it will trigger malaria).
•
As in Thai and Ayurvedic traditions, food plays a major role in healing and maintaining
health. Help in adjusting to the American diet would be important for Karen.
FAMILY STRUCTURE
Familial roles, responsibilities, and relationships
• At present, Karen families are normally patriarchal. A senior in the family is highly
respected, whether or not he or she is the head of the family.
• People in the past have had many children. It is common for many generations to live
close to each other. Children are looked after by everyone in the community. Due to the
conflict in the Karen state, family members have often been forced to live separately
from loved ones.
• Although it is more common for the daughter and her husband to stay and take care of
her seniors in the family, the son can also assume this responsibility. Adoption of a
child is socially acceptable, especially if the parents are no longer able to take care of
their children.
• The men will work outside the home. The women do the housework such as cleaning,
cooking, and caring for the family members and children. But back home women also
collect water, gather firewood and work in the fields.
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• Men are honored in the home, however the woman's opinion is also well respected. In
some respects Karen culture is primarily a matriarchal society. The head of a spirit clan
is always a woman and the husband becomes part of the wife's clan through marriage.
(Infomekong, 2008)
• In community or family gatherings, young Karen would normally take the back seats
because the front seats are quite often reserved for the older people or seniors.
HEALTH BELIEFS, CULTURAL PERSPECTIVES ON HEALTH AND HEALING
Traditional medicine, Herbal medicine and home remedies
• The Karen traditional medicine borrows from both Indian Ayurvedic systems, including
Alchemy, and Chinese medicine. The Karen people from the remote jungles also exhibit
a diversity of other folk healing traditions.
• A senior should be asked about family involvement in their healthcare. If a patient is
unconscious, family members are involved in making healthcare decisions.
• Seniors will generally feel more comfortable with same-gender interpreters due to the
healthcare issues that may be discussed during their hospital visits.
• Herbal medicine remains of great importance in Burma due to the lack of money for
occidental medicine and the anti-imperialist (and anti-modernization) notions of the
military regime.
• However, the Karen refugee community is accustomed to accessing health care through
a clinic setting, as they have lived in the refugee camps where health care is provided by
NGOs (non-governmental organizations).
• The majority of refugees prefer the services of the International NGO health centers in
the camps. Still, there are traditional services available, though in insufficient quantities.
There is a small network of traditional healers along the border.
• Healing traditions using herbalism have been somewhat opposed by the Christian
Karen, though there are efforts to revive the ancient practices. Barriers include a lack of
access to the needed plants, a general resignation to apathy in the camps, and a
decreased value placed on tradition especially by the youth.
• Some people believe that modern medicine can cure their ailments, while others would
prefer to use their traditional remedies if available. Sometimes people think they have
bad blood and need to be bled.
• There isn't a fear of occidental medicine found in other ethnic groups. Most Karen
refugees have had enough contact with western people and doctors to understand their
ways quite well, and these populations probably won't have as many problems
adjusting to western care upon arrival in Canada. However, refugees coming who
haven't lived in the camps for very long or at all will be more likely to be afraid of any
modern practices.
• One interesting note is the confusion between vitamins and other medications. Karen
people use the same word for both and only a few people understand the difference.
• The Karen have a certain yearning for bitter and sour foods, especially vegetables, and
many of these are eaten as a preventative.
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Chronic Diseases
• Intestinal Problems is a common disease among Karen people
• Many Karen people experience stomach problems and diarrhea.
• A major issue among the Karen people is the prevalence of gastric ulcers. It seems that
it is mainly the result of mental stress in their lives and a diet high in hot chili peppers.
Many meals in the past may have been simply rice and chili.
• A lot of people have intestinal parasites. They don't have energy even though they eat.
Some common parasites include hookworm, which can contribute to iron deficiency,
and giardia.
• According to a UN envoy, Burma has the lowest per capita spending on health care in
the world. Malaria, respiratory infections and diarrhea, and anemia are devastatingly
common in Burma.
• It is also a regional incubator for HIV/AIDS, TB, measles and typhoid fever. Due to the
civil war, there are many victims of landmines as well.” (World Aid Foundation)
• Backpack Relief teams bring cross border aid and medication into the conflict areas.
These backpack medics are often targeted by the Burmese military.
Relationships and attitudes towards health care professionals and institutions
• Karen people are mostly from rural areas. They may be ashamed, embarrassed and
hesitant to give information to their health care providers, and this may be true
especially for female patients.
• Most Karen agree with and accept the western health care system and practices, but
still are very hesitant to visit American doctors.
• The patient-provider interaction may benefit from having a Karen caseworker. If
possible, consult with the patient after they have seen a doctor to clarify confusion or
misunderstandings and discuss issues in preparation for the next doctor's
appointments.
SOCIALIZATION AND HOSPITALITY
• The basic and the traditional Karen dress for men is a red cotton shirt with woven
pattern and blue wide-leg trousers. Married women wear red skirts and red shirts more
decorated than the men's. An unmarried woman traditionally wears a white, long sack-
like dress. (Infomekong, 2008)
• ‘a-nah-dah’ expresses Burmese cultural value –“an attitude of delicacy, expressive of a
solicitousness for other people’s feelings or convenience”
• The Karen are very hospitable and will expect any guests to eat with them. They are
more conscious of people as opposed to time. Making and sticking to strict schedules is
a difficult adjustment for many.
• North Americans might see rushing from one appointment to the next as efficient, while
the Karen might see it as being rude to the person who is being left behind.
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• Making long range plans and setting goals is a rather new concept for most Karen. As a
rule, the Karen will take life as it happens to them.
DO’S AND DON’TS
• When you are walking past someone, you duck and bow your head lower, especially if
you are walking past two people having a conversation. One should avoid walking in
front of those who are seated. One should walk behind them or ask for permission first.
• Direct eye contact is sometimes not considered polite, as it is a sign of equal status.
• Normally the Karen people walk behind those who are older or senior to them.
• Folding one's arms in front when talking to another is a sign of respect unlike in
American culture.
• Pointing with the feet or showing the bottom of one's feet or touching the head is
disrespectful.
• One does not pick up something belonging to another person. When handing something
to someone, it is respectful to use two hands rather than one.
• One first refuses invitations to eat as a matter of respect, and then eventually accepts
modestly. Saying “no” the first time is often a way of being modest.
• Shoes are not worn in the home
• In community or family gatherings, young Karen people would normally take the back
seats because the front lines seats are quite often reserved for the older people or
seniors.
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