They traveled from Tibet and China and settled largely in the hills bordering the eastern mountainous region of Burma. In the 8th and 9th centuries, the Burmese also began migrating to the area north of what is now the Karen state.
When the British colonized Burma in , these groups all became part of Burma. With the arrival of the British colonists to Burma, the Karen people hoped to escape oppressive rule under the Burmese. Tensions between the two groups reached a high point during World War II when the Karen sided with the British allies and the Burmese fought with the Japanese. Burma achieved independence from the British in , but the Karen people were not granted rights to their own land, and the Burmese once again became the dominant ethnic group.
The military regime established in continues to oppress the Karen and other ethnic groups in Burma today. Burmese soldiers terrorize Karen villages every dry season by burning their villages, killing or torturing civilians, and raping women and girls. Due to the annual threats to their lives and villages, many Karen must flee across the border to refugee camps in neighboring Thailand.
Saay Tae Tae talks about the plight of refugees ». Travel is very restricted by the army, and the people have no money to pay for transport," Saay said. Mae La, which sits about five kilometers from the Myanmar border, is huge -- one expression of its age; the camp has been running for almost 25 years. Watch an audio slideshow on Mae La ».
The camp's population is mainly made up of families of farmers and low-income workers, while religious lines are more or less evenly divided between Buddhists and Christians. Some of the violence has followed them, such as when the Myanmar army attacked Mae La in Since then, it's been peaceful, though according to TBBC, tensions rise every dry season -- the preferred time of activity by the Myanmar army. But while refugees have escaped direct violence, other problems exist. There's little or no employment, education for children is minimal, and boredom is rife.
Camp dwellers not only have to deal with the horrors of their past, but the grim outlook of their future. Despite this, the people at the camp appeared stoic, and carried with them a sense of humor and pride. However, it is more likely that the Karen Buddhists merge Buddhism and Animism with a very fine distinction between the two religions. Before the introduction of Christian missionaries in the s, many Karen worshipped a form of animism.
Each of these Lords had a number of servants, or ghosts, created from the spirits of people who had died violent deaths, that would roam around the Karen homeland smoking pipes and armed with spears and swords. It was believed that touching them, even accidentally, would strike the victim with disease with the only cure being blood sacrifices.
Other similar legends tell of the animal spirit Na, who in ancient times had ordered the Karens to eat a mixture containing the flesh of every creature. If the Karen failed to eat each kind of flesh, then the spirit of that creature would in turn consume them.
Since that time, sickness and death have come upon the Karen because they were unsuccessful in consuming the flesh of every creature. However, the most dangerous of the spirits are a particular seven who kill the Karen. The tha forms the conscience, and so deals with moral nature.
In Karen animism, there are also many spiritual beings. The more important spiritual beings have human attributes and have the power to control the destinies of mankind. A few in this group are spirits, some who have divine, god-like powers, who are responsible for the crops, or another that is considered the ruler of hell.
Even though many Karen may consider themselves as Buddhist believers, a large proportion continues to follow and believe in the traditions of animism, and often times mix the two beliefs. Formed in the early s, the Lehkai mixes Buddhism with traditional legends from the Karen Golden book, and continues to integrate some animistic beliefs. There are over students in 17 schools that teach the Lehkai. One of the five stated aims of the Lehkai is to prohibit meat and flesh to be cooked for meals, as well as to prohibit alcoholic beverages.
Based on religion, practices differ concerning death. Christian Karen bury their dead, while Buddhists and Animists perform cremations. When a person dies, a feast is prepared and there is often chanting and drinking. Spirits are encouraged to leave the area rather than hang around the community. Ghost stories are related about deceased members of the community who have been offended and continue to haunt an area.
The idea of organ donation is very foreign. The Karen traditional medicine borrows from both Indian Ayurvedic systems, including Alchemy, and Chinese medicine. The Karen from the remote jungles also exhibit a diversity of other folk healing traditions.
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 quantity. There is a small network of traditional healers along the border. Healing traditions of 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.
The health NGOs have contributed to this by not working with local healers or encouraging proven traditional practices, and prohibiting traditional midwifery. 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. One interesting note is the confusion between vitamins and other medications. Karen use the same word for both and only a few people understand the difference.
Karen have a certain leaning for bitter and sour foods, especially vegetables, and many of these are eaten as a preventative. 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. Tumeric is used medicinally both internally and on the skin. There are many food taboos e.
As in Thai and Ayurvedic traditions, food plays a major role in healing and maintaining health. Help adjusting to the American diet would be important for Karen. A CDC investigation indicates that for Burmese refugee children there is a relatively high risk of lead exposure in the camps. Cultural practices and traditional medicines are among the risk factors for elevated BLLs among Burmese refugees in the U.
A major issue among the Karen 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. Some common parasites include hookworm, which can contribute to iron deficiency, and giardia. Most Karen people have had malaria.
Other health issues may be complicated by residual effects of malaria. In Thailand, malaria is rare but in the IDP areas, malaria is rampant. If one gets malaria and medication is available, a seven day course is taken and the symptoms of the disease is gone. However, many Karen think that that when they have a fever that they have a reoccurrence of malaria. Malaria is so rampant that any fever is automatically considered malaria though it could be dengue fever or any other kind of fever.
If you want to ask about malaria, you have to ask clearly do you have malaria with the kind of parasite that you have to take quinine treatment for. This can be very confusing for doctors as patients may come to the doctor saying that they have malaria. The Karen Community in Minnesota related that the doctors are very sensitive when they tell a Karen person that they have Hepatitis and explain that they are carriers of the disease if B or C.
The doctors tell them not to worry and the patients feel more comfortable if the doctor will tell them directly what to do. They listen to the doctor, have check ups every six months and the doctors let them know that they can have medicine if they are bothered by the symptoms. When people find out they have Hepatitis, they will have many questions about food. In Karen culture, there are a lot of rules about you can eat this, you cannot eat that.
There is fruit and meat you cannot eat. One cannot eat fish paste. The Karen refugee population is tested for active TB in the refugee camps before resettlement in the United States. There are programs to treat TB. Medication is prescribed that needs to be taken for 9 months to lessen the chance that they will develop active TB.
Anemia, especially mild anemia with microcytocis, is a commonly encountered problem among recently arrived Southeast Asian immigrants. Unnecessary work-ups, including hemoglobin electrophoresis get ordered if the clinician is not aware of the increased prevalence of these lab findings in an otherwise normal person.
Malaria, respiratory infections and diarrhea, and anemia are devastatingly common in Burma. Due to the civil war, there are many victims of landmines as well. Backpack Relief teams bring cross border aid and medication into the conflict areas. These backpack medics are often targeted by the Burmese military.
These clinics provide limited healthcare, maternal and child health, family planning information, vaccinations and nutrition programs. Karen people are mostly from rural areas. They may be ashamed, embarrassed and hesitant to tell 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.
Refugees living in the border region are not allowed out of the refugee camps and cannot work. 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.
Committees oversee community health clinics, support the school system, run camp security systems and oversee the administration of justice. People maintain traditional crafts such as weaving. Burmese Refugee Health Profile The information in this refugee health profile is intended to help resettlement agencies, clinicians, and public health providers understand the health issues of greatest interest or concern pertaining to Burmese refugee populations in the United States, as well as their cultural background and circumstances.
More information about Karen culture, history, kinship, religion, economy. Section on Religion and Expressive Culture gives information about spiritual beliefs, practitioners, ceremonies, arts, medicine and afterlife. Karen-Burmese Refugees - An orientation for health workers and volunteers Information about the Karen-Burmese refugees culture, living conditions and health risks. This resource provide general cultural information, while recognizing that every family is unique and that cultural practices will vary by household and by generation.
This food and nutrition handout from USCRI is designed to communicate basic nutrition information to refugees and immigrants in order to help develop positive nutrition and lifestyle habits.
Pwo Karen Profile. International Rescue Committee. Keenan, P. Museum of Karen History and Culture. Thailand Burma Border Consortium. VF Fairbanks, G.
Hemoglobin E trait reexamined: a cause of microcytosis and erythrocytosis. Blood, 53, Ward, J. If Not Now, When? A Global Overview.
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