PATIENT CARE
Many Karen and Karenni refugees have
had exposure to Western medicine in
refugee camps, but in many cases
people have reported feeling ashamed
or embarrassed coming to the doctor if
a language barrier exists and leads to
confusion. With women especially a
safe environment needs to be
established as many refugees have
been victims of rape or abuse. Direct
eye contact may be viewed as impolite
(they won't make it) as it is a sign of
similar status.
SOURCES
https://ethnomed.org/culture/karen/
https://www.everyculture.com/East-Southeast-
Asia/Karen-Religion-and-Expressive-Culture.html
https://www.buffaloschools.org/site/handlers/fil
edownload.ashx?
moduleinstanceid=4051&dataid=23891&FileNam
e=karen_people%20book.pdf
https://digscholarship.unco.edu/cgi/viewcontent
.cgi?article=1079&context=urj
https://www.unthsc.edu/texas-college-of-
osteopathic-medicine/wp-
content/uploads/sites/9/Burma_Refugee_Health_
Profile.pdf
THE KAREN
& KARENNI
PEOPLE
A Brief Cultural Background on
Refugees from Myanmar

HISTORICAL BACKGROUND
Myanmar (Burma)
A country with a long history of
political unrest, Myanmar has been
under the rule of a military regime for
the last 70 years. Within the past 20-
30 years the U.S. has seen an influx of
refugees fleeing the country due to
extreme ethnic and religious
persecution and violence. With more
than 130 ethnic minority groups, the
country is very diverse. The two most
prominent cultural groups residing in
the U.S. are the Karen and Karenni.
FAMILY DYNAMICS
Family is extremely important to the
Karen people. The immediate family
unit is the strongest but reaches to
the extended family as well. It is seen
as the children's responsibility to take
care of aging parents. Relatives
should be as informed and involved
in patient care as allowed and
desired.
COMMUNICATION
Karen and Karenni people are known
to be extremely friendly and
welcoming. When greeting others,
familial terms are often used even for
strangers, as they do not convey
familiarity. Traditionally Karen do not
bow or shake hands, but they will
often shake hands using the right
hand while gripping the forearm with
the left hand as a sign of respect.
RELIGIOUS BELIEFS
Most common among Karen and
Karenni is the practicing of Animism or
Buddhism. However, many have
converted to Christianity and even
Catholicism. Those not practicing
Christianity often have merged
Animism and Buddhism. The main
belief is the body is made up of two
parts, the the, or spirit, and the k'la
(shade), or flesh. The seven spirits that
are responsible for attacking the Karen
mainly attack the k'la. Charms and
medicines are used to protect the
body, but they also believe that their
k'la can be reincarnated.
HEALING VIEWS
Traditionally, the Karen and Karenni
people emphasize health as the
balance of "hot" and "cold" elements in
the body. There also believe health
and illness are more supernatural.
Common healing practice include
eating certain foods or natural
medicines to restore temperature
balance. The extreme weather changes
in the U.S. may cause anxiousness or
uncomfort. .
ILLNESS VIEWS
When a person falls ill, a traditional
practice was to sacrifice a chicken,
viewed as sacred, and spill the blood
and bones to interpret answers
regarding the ill person. Food is also
very central to illness as certain foods
have to be avoided for ailments or
consumed for others.
BIRTH & REPRODUCTIVE ISSUES
Children are very valued in Karen and
Karenni culture, and having children is
considered a great joy to many
mothers. Traditionally, Karen and
Karenni women have dealt with labor
pains and complications by spilling the
blood of a chicken on the woman's
back as the chicken is seen as sacred.
Birthdays are often not recorded or
celebrated, but they are sometimes
recognized according to the Buddhist
or Western calendar.
NAMES
Karen and Karenni only use their given
names and do not change their names
when married as they often don't have
family or last names. Many names
have multiple parts in English and are
chosen for flowers or desired qualities
like, Paw Htoo, or Gold Flower or Law
Eh, handsome.
DEATH AND END OF LIFE CARE
Non-Christian Karen categorize death as
either "natural" or "violent" and some
believe in an after-life with different
realms. When a person dies they wash,
dress, and bury them in their finest
clothing in a mat or coffin while singing
or playing music to send off their spirit.
Upon returning from the burial, people
would traditionally construct obstacles
to prevent the person's k'la, or shade,
from returning. This is traditional
among Animists and Buddhists, while
Christians have simpler funerals.