Mothers Day Immigrant Style

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 I have written a previous blog about two mothers in Korea and China who I will never know but yet I honor each year on Mother’s Day.  This blog  post is about those moms from throughout the world who moved to America and have raised their children in a world where their family looks different, may dress differently and are caught between two very different cultures. While most of us will celebrate our mothers this weekend for providing us with guidance, car rides, food and love, immigrant mothers in this country have done even more to make sure that their children have a better life than they did. They have left their country of birth, their extended families and all that they have known, to move to America and start over so that their children would have more opportunities. I recently had the wonderful opportunity to sit down with four of these women and asked them to share their stories.

Mona was 15 when she moved to the US with her parents and three siblings from Somalia. Both of her parents learned English and held more liberal views, but still believed that girls needed to be more submissive in their behavior than boys. Mona often needed to stand up to her parents in order to gain much of the same independence that was granted to her older brother and friends. Because of the ongoing conflict in Somalia, her mother has not had an opportunity to return to her home to reconnect with her siblings and parents. If she had remained in Somalia, childcare would have been shared between relatives as well as cooking and socializing. Raising her family in America left her much more isolated and without a support system when her independent daughter brought home a Caucasian boyfriend who she would later marry.

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Hieu entered the US from Vietnam at age one, accompanied by her parents and two older brothers. Their family was sponsored by a church in Hinckley. Unlike Mona, who grew up in a diverse metro high school, Hieu and her family were the only Asians in a rural community. Although Hieu never thought of herself as different from her classmates, she remembers her mother struggling to assimilate as she had a difficult time learning the language and mourned the lack of a community of women and the comfort foods of Vietnam.  A monthly trip was made to Minneapolis to purchase some of the ingredients for homemade Vietnamese food. This move to America had been Hieu’s dads plan and her mother went along with the idea as she believed her children would have greater opportunities in America rather than in Vietnam, which was just starting to rebuild after the war.  Although she has had a few opportunities to return to Vietnam, the memories and lost connection with family makes the trip emotionally difficult.

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Jackie came to the US from Kenya at age 19 on an academic scholarship to attend college. Her parents had saved and worked 2 and 3 jobs in order to put her and her 8 siblings through boarding schools and college. As each child graduated from college and got a job, they were expected to give their paycheck back to their parents in order to help the next child in their education. The expectation was even higher for Jackie as she had the opportunity for a well-paying job in America and could send larger funds back to Africa to provide for education for nieces and nephews.

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Jackie’s mom

Gladys won the green card lottery at age 36 due to the medical needs of her son with sickle-cell. The medical care that he could receive in the US far surpassed what was available in Kenya.  Gladys had worked as an RN in Kenya and soon found a job in the US but had to move here 3 months before her husband and children could follow.  Once her family arrived she noted that the big difference in this country was that she was not able to afford a maid or in-home childcare provider, as she had done in Kenya. Like many working moms in America, she was faced with a second full-time job when she returned home from her paying job as a nurse.

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Gladys’s mom

Despite coming from different parts of the world and at different ages, all of these women shared with me many of the same stories. Feeling responsible for family members that remain in the home country – whether that be paying for the education of a niece or being asked to help fund the purchase of a house by a cousin you have never met. Trying to keep parts of the home culture alive in your children while also allowing them to feel fully American. Sharing stories of the struggles you had to overcome to make a life in this country in order to combat the entitlement that can be a pervasive part of teen life in America. Creating a middle ground in your nuclear family between the opposing pull of the individualistic American culture and the community culture back home.

Observing a woman become a mother is something I see happen every day in my work as an ob/gyn physician. Giving birth is not what makes a mother. That task is accomplished in the sacrifices mothers make for their children and the love they bestow on them. Immigrant mothers have often made one of the largest sacrifices imaginable – leaving all that they know to try to create a better life for their children in a foreign land with a foreign language. I often wonder if I would have the strength to do the same.

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Left to right: Gladys, Jackie, Hieu and Mona

 

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The Terrorists Within our Midst

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My heart was saddened when I read the headlines on Friday about another bomb incident in London. I thought of not only the 22 individuals that were affected by this violence but also the thousands of Brits that need to use the subway each day to get to their jobs and back home again. Going to work should not involve terror about what may happen before you start your job.  Soon after the news appeared it was listed as a “terrorist event” and further headlines contained the words travel ban, building a wall, immigrants and terrorists. If we can just prevent “those” people from coming to our country we will be so much safer.

But there is a more dangerous, violent and ruthless killer in our midst.  Post Hurricane Harvey, He appeared at a football party in Texas and killed his ex-girlfriend and eight others.  Last week, He walked into a school in Spokane, Washington and killed a classmate. Over Labor Day, He murdered his pregnant girlfriend and then appeared with her parents pleading for someone to find her. And these were only the high-profile events that made the national news in the last 2 weeks. On average, three or more women are murdered by their boyfriends or husbands every day in the US. All of the above killings were done with a gun.

Today, the President of the United States of America, someone who is supposed to be a role model for not only America but the rest of the free world, tweeted a video of himself hitting a golf ball that struck Hillary Clinton in the back and knocked her down. If you watch the video, you understand that the golf ball hit by Trump did not actually strike Clinton. THAT is not the point. The point is that we have an epidemic of male violence in this country and our President is signaling with this tweet that it is ok to physically strike down someone with whom you disagree.

I would challenge every American to think about the real terrorists in our midst – young men who believe that using violence and guns is a solution to their problems. These men are not being recruited over the internet by a religion, they are not recent immigrants from a country in the Middle East, they don’t have long beards or speak a different language. The terrorism that they create is much more prevalent and difficult to stop. They have almost unlimited and immediate access to firearms so that they can destroy before their temper cools down. No elaborate terrorist network is needed for their plans.

Many will brush off President Trump’s latest tweet as just a joke against his former running mate. Those of us who rush to pronounce judgment will be considered uptight liberals and not able to enjoy humor.  If you are a woman in this country, think about what tone is set when we can consider a woman being intentionally struck by a much physically larger man as humor. If the President can do it and Americans laugh it off, why isn’t it justified to put a woman in her place with a fist or threaten her with a gun?

Just imagine if we could use a small portion of the proposed funds for a wall on the southern border of our country and use the money to implement a school based program starting in middle school that addresses safe outlets for anger and treating each other equally. Because the terrorists aren’t across the ocean trying to get into the US …. they are already here.

My Day of Confusion at Work as an Ob/Gyn

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During the delivery of a baby last week, the parents informed me that they had decided not to know the sex of the baby prior to delivery. I joked that I would need to watch a You Tube video prior to the momentous event so that I would be reminded of how to correctly identify the “parts” as either boy or girl. Luckily, I got it correct under pressure of both the delivery and the gender identification and disaster was averted. But it did allow me to reflect on how important this subject has become for the newest generation of parents.

When I first started in practice 25 years ago, routine ultrasound at 20 weeks gestation was not standard practice. The quality of ultrasound was far inferior to current imaging and even when looking for gender, you could be mistaken or not obtain a clear picture. Although not evidence based, routine ultrasound at 20 weeks gestation is now the norm and anticipated from the time of the first OB appointment. The purpose of the scan is to rule out major structural abnormalities but expectant moms see it as “finding out the sex of the baby”. Relatives and siblings are invited to view the unveiling and crowd into the small, darkened room for the 45 minute procedure.

Reveal events have now become the mid-pregnancy social occasion. The sex of the child is concealed in some way and the expectant parents “reveal” boy or girl status to invited guests. A competition seems to have started for favorite You Tube video/creativity with these events. Subsequently, our office has been swept up into the planning process for the Reveal. Following are just a few of the duties that our Ultrasound Techs have been asked to perform.
1. Call the Bakery and note boy or girl for the couple so that a cake can be baked with either a blue or pink interior frosting, revealed when the cake is cut.
2. Stuff the appropriate color golf balls into a box so that when the balls are hit they emit either a blue or pink cloud of dust.
3. Stuff a pinata with either blue or pink candy.
4. Write the sex of the baby on a piece of paper and fold in such a way that prying eyes can’t deduce the writing. That paper is then given to a favored family member to see, while everyone else stays in the dark until the day of arrival.

Studies have shown that parents bond better with their newborn when they are aware of the sex of the baby prior to delivery. It would also make sense that they would have a name for the baby at delivery, but this seldom seems to be the case. With the current generation of parents, planning how events will unfold during the delivery as well as in the first days post-partum is a priority so it only follows that knowing the sex of the baby would be part of the plan. It is only when they have parented for a few weeks or months, that they come to realize that this wonderful journey is full of detours and bends in the road and not a straight path.

Here’s hoping that I will get the sex correct the next time I am under pressure to perform. I have the You Tube video bookmarked for quick reference.

The cost of being a woman

 

Two headlines caught my attention this week. One focused on the luxury tax for tampons that is part of the law in 46 of the 50 states. The other headline was buried in all of the news about the Republican sponsored Health Care Act.  Tom Price, head of HHS, would like to see the co-pay for contraception reinstated. As part of the ACA, contraception is free under the majority of health care plans. Both of these costs are charged to women. On a monthly basis this may not seem too costly. But let’s look at the average sum that a woman would need to pay over her lifetime for both tampons and contraception.

Tampons: an average woman uses 30 tampons for each menstruation. A box of 36 tampons costs $7 at Target. That amounts to 360 tampons per year or $70. When multiplied x 35 years that costs a woman $2450.

Contraception: Prior to the ACA, an average co-pay per month for birth control pills was $30. If a woman were to start pills at age 20 and continue to age 45 it would cost $9000 for contraception.  The average family size is 2 children, so you could subtract $1000 for the time it takes to become pregnant and the pregnancy itself. I would argue that there are other costs during that time that offset the $1000 (maternity clothes, nursing bras etc…) but those are probably considered “luxury items” by society standards.

$10,450 is the total cost of tampons and contraception for a woman during her lifetime. But some of our lawmakers want to extend this burden even further, questioning why men should have to help pay for maternity care as part of health insurance. Despite the backing of Ivanka Trump, I doubt that the current legislature will approve any bill that provides for paid maternity leave. Women caregivers are the norm for elderly parents who need assistance and many choose to decrease their paid work commitments to provide this care.

At what point will our society honestly discuss the financial inequalities that exist between men and women?  Male partners should share the finances of contraception – much cheaper than the cost of supporting  a child to age 18.  Women should not be the only members of society that are burdened with the cost of maternity care.  Removing the luxury tax on tampons is a no-brainer as I have never heard any woman describe her period with the work luxury.  And I have heard many words used to describe periods! Paid maternity leave is present in  every  country in the world other than the US and Papua New Guinea. If we want to make this country great, maybe we should start with the women.

 

International Women’s Day #Be Bold for Change

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The message for today, International Women’s Day, is to call on yourself and others to work together to forge a better working world – a more gender inclusive world. As I write this entry, I am reflecting on the headlines this week that are not exemplary of that aim.

  1. Stories about nude photos of female Marines that were published without consent to secret websites.
  2. Moves to defund Planned Parenthood – an organization that provides contraception and cancer services to low-income women
  3.  A potential ban on refugees, the majority of whom are women and children,  from war-torn countries.

Discouraging to say the least. But them I remind myself to take a look at the world now as compared to 50 years ago, both for myself and for women throughout the world. When I finished my Ob/Gyn residency in 1991, 22% of all Ob/Gyn providers were female. Currently 85% of Ob/Gyn residents are female and since 2003 female applicants for medical schools have outnumbered male applicants. Most college campuses are 55-60% female. Women are making their way up the ladder in education and the next mountain to scale is the workplace.

In the greater world, extreme poverty has been markedly reduced over the past 25 years. Women and children are disproportionately represented in this sector so will see a greater benefit when they have enough food to make them more productive workers. Educational opportunities for women in the developing world are increasing at a rapid rate and with education comes the ability to control the size of your family and participate in higher earning jobs.

We still have work to do in this world to equate opportunities for women. #Be Bold for Change within your neighborhoods, places of worship, social environments and workplace to create equality for women,  because when we all have the same opportunities everyone benefits.

Traveling with an Immigrant

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Last weekend, we left Minneapolis for Seattle. At the time the plane departed, the 3 judge panel was still deliberating the enforcement of the travel ban imposed by President Trump. When we landed 4 hours later the news had changed. The judges had unanimously ruled against the travel ban and our country was now in legal limbo. I looked at my traveling companion, an immigrant to this country 17 years earlier, and thought about how differently her life would have been if she had not immigrated to this country. Her parents on both sides of the Pacific made financial and emotional sacrifices so that she would have education and life opportunities that were not available to her in her home country. This immigrant is my daughter, born in a Korean society that does not have social support for single, unwed mothers and their children. We were visiting a college in the Pacific Northwest, far from her home in Minnesota but closer to her birthplace both in terms of geography and culture. I hastily brushed away tears as we grabbed our luggage to exit the plane (those tears might be the reason I forgot the umbrella in the overhead compartment), thinking about stories of families in the news that had been denied entry to America earlier in the week and who would now be reunited with family members already here.

Unlike the immigrant families from the 7 banned countries, my daughter is the beneficiary of white privilege. My husband and I were able to afford the adoption fees because we had the advantage of college educations and professional jobs. She grew up in an upper middle class neighborhood and attended above average public schools. She has participated in extra curricular sports and activities, attended summer camps and traveled throughout the United States and internationally. A college education is expected by her parents and peers and she has many excellent choices. Her high school friends are multi-racial and from many different socioeconomic backgrounds. Unfortunately, the majority of this would not be possible if she happened to be from a Muslim majority culture. Why does the color of your skin in this country dictate what your future may hold? When will Americans be able to look past skin, hair and clothes for the qualities of the person underneath?

Today, February 16th, immigrants are trying to remind us of the contributions that they provide this country by staying home from work and school. Ethnic restaurants are closed, children are staying home from school and college and adults are staying home from work. Some service businesses will have a difficult time functioning, but isn’t that the point? Until we realize the contributions of immigrants in our daily lives, only then are we better able to understand how these new immigrants can benefit America.

I received a phone call from a friend this morning, torn between staying home with her husband and children in solidarity vs feeling guilty about her job that is difficult to fill on last-minute notice. She is a citizen of this country, born here to an immigrant mother. Her husband is a Dreamer, brought to this country illegally as a child by his parents. Despite multiple attempts to obtain citizenship, he has not been successful. He has worked full-time since his teen years, supporting his family and contributing to the American economy. These are the difficult stories behind the majority of immigrant families. They are not here to bring in drugs, commit crimes or spread terrorism. They are fleeing their home countries due to these problems, looking for a better life in a country that was founded by immigrants. What would this world look like if white privilege meant that those of us who are bestowed this advantage by birth use it to offer a helping hand to guide others as they ascend the mountain of life? That is the world that I would love to live in.

My upcoming Caribbean vacation – Haiti and warmth!

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I am sitting in my kitchen in MN this morning contemplating all of the errands that I need to accomplish before I journey to Haiti in 3 days. The current temperature here is -8 with a projected high of 0 degrees. The heat and humidity of Hispaniola (collective term for the island shared by the Dominican Republic and Haiti) is appealing, but this is far from a beach vacation. Our team of 14 will be performing surgery for 5 days as well as participating in a distribution of 114 menstrual pad kits to local school girls. However, the most worthwhile portion of the trip will be connecting with Haitian friends that we have not seen for a year.

In 2006 when I participated in my first surgical mission trip, I thought it was worthwhile, that we helped many people and that I was not going to do this again. It was a checkmark on my bucket list and I could start moving on. I failed in that I have returned 1-2 times a year to the island and my bucket list has only grown longer with fewer checkmarks. Sometimes failure is good.

My understanding of this island nation has increased dramatically since that first trip, while my perception of issues as black and white has changed to various shades of grey. For every beneficial initiative, there can be a downside. Initiating a HIV program in a hospital and hiring additional staff – beneficial. Existing staff now wants to be paid extra to take care of HIV patients because they believe there is additional outside dollars to support this. Bringing toys and new clothes for the orphanage kids that attend a local school – beneficial. More children are abandoned at the orphanage because poor Haitians see orphanage kids having a better life than they can provide. These are only a few of the examples that I have seen over the years.

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Father Charles organized a meeting of all ladies in the microloan program in Ranquite. “I teach them the way to use money, they share their experience, how the microloans service is benefit for them, it helps them to take care their families. It’s was an appointment of brotherhood.”

Our current microfinance program that lends women money for growth of their small business (Helping Haiti Work) is not without concerns. I do not live in Haiti and administer this program, so I have to rely on others to be truthful about distribution of the funds and respectful coaching of the recipients. The other arm of this program involves employing Haitian seamstresses to construct reusable menstrual pad kits for sale in the community. The average Haitian woman who needs this product is not able to pay enough to cover the cost of supplies/wage to seamstress. Do we distribute the kits for free and continue to depend on donations to subsidize the program? Or do we focus on selling to NGOs that have more funds and can cover our costs?

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Seamstresses assembling 300 menstrual pad kits

While these competing interests are playing tug of war in my head, I am gratified to report that we finished 2016 by granting 25 new loans and started 2017 by filling an order for 300 menstrual pad kits that will be distributed to school girls near Gonaives. Sometimes it is more important to think like a Haitian – appreciate today and don’t worry so much about tomorrow. That means I need to try to appreciate this cold MN weather while trying to finish all my errands today.