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In search of healers--Southeast Asian refugees in the American health care system.

Healing is the alleviation of sickness, which includes both medically defined problems of pathophysiology (disease) and personal definitions of not being well (illness). Refugees from Southeast Asia now have a special need for healing because their health problems are changing from those of concern to public health, which are well documented and for which there are known effective treatments, to those that are primarily a personal concern and that are difficult to diagnose and treat effectively because of their chronic nature and their cultural and emotional components. The finding among refugees of physical complaints for which there is no identifiable medical cause is explained by cultural tendencies in Southeast Asia that promote focusing on somatic symptomatology, and by a delayed somatic response to refugee trauma. To prevent escalation of medical intervention, physicians need to be sensitive to Southeast Asians' attitudes toward health and their expectations and apprehensions regarding Western medicine.