A COVID-19 Narrative: Intergenerational Vietnamese American Family Experiences
by Huong T. Duong (UC Irvine) and Karen Bui (Tulane School of Medicine)
April 30th this year marks the 45th anniversary of the Fall of Saigon, which we remember as a time of uncertainty, conflict, and great challenges for Vietnamese refugees. There are parallels to be drawn between the immigrant struggle and the current COVID-19 pandemic. As second-generation Vietnamese Americans, we acknowledge our privilege and write this narrative from our own lived experiences. Karen is a 3rd-year medical student at Tulane University and Theresa is a 4th-year public health doctoral student at UC Irvine. We are both training to advocate for the health of the Vietnamese community through research and practice. While we are deep into our studies, COVID-19 has drawn us back to our family and reminded us to prioritize protecting our family members during this pandemic.
Our relationship with our family (including grandmother, parents, aunts, uncles, siblings, and cousins) can be described as a close one. We talk and share information with our family members via group chats daily. The purpose of this narrative is to explore our intersecting identities, examine intergenerational conflicts, and address concerns regarding the mental health of our loved ones. We bring to the table two stories of our personal experiences as a medical student, public health doctoral student, and health advocates for our extended family.
Karen’s Narrative
Since starting medical school in the Deep South, I have been luckily unscathed by the tinge of racism. When news of COVID-19 broke out, I was afraid of how this would change. I responded to my own fear of racism by becoming more wary while at the hospital. For example, I tried to better control my seasonal allergies, so I would not sneeze or use tissues, which might scare my patients. When hospitals began implementing COVID-19 symptom screening, the screeners at the entrance did not initially screen me. However, on the fourth day of screening, there was a different man, who stopped me and asked me every screening question. “Good, they’re doing what they’re supposed to now, keeping us all safe,” I thought to myself. When I joined my peers in the student room,I asked if they were screened too. Not a single person was stopped, despite entering only moments before me. None of them shared my skin tone. No one thought much of this, but I did. I quickly had to brush it off because what I was learning in clinicals took priority. About a week after this incident, medical students were dismissed due to the pandemic, so I quickly returned home to make sure my family was safe. I began fielding questions about COVID-19-like symptoms, whether or not family members and friends should go to the emergency room, medications, and what steps my immunocompromised family members should be taking. Though I felt helpless in a larger sense because I could not help at the hospital, I gladly took on the role as a health advisor to my family, with the disclosure that I am still merely a doctor-in-training.
As I began to see the changes in my own life unraveled by COVID-19, I called to check on my grandma, the most at-risk person in my family. She was sad that I couldn’t see her when I got home and did not understand why I was self-quarantining. She said she never imagined that my generation would live through something like this. Seeing people line up to clear out the grocery stores brought up memories of when she witnessed food shortages and starvation as a child in Vietnam. Since she lives with my aunt, who works as an obstetrics nurse in the hospital, I advised her to keep a distance and remain in separate areas of the house. She told me she would be fine because my aunt only works with pregnant women, not people with “the virus.” In my semi-fluent Vietnamese, I tried to explain to her how COVID-19 spreads, and how social distancing can help mitigate it. Despite my efforts, she scoffed, “I’ve lived through worse.”
Through the years, I have been told stories about what “worse” actually means to my grandma and the rest of my family. They lived through the Vietnam War and have seen the unimaginable on their journey to the United States. Because of these experiences and having actually run out of necessary supplies during a crisis, they often find the need to stock up on items they do not need at the moment. This “hoarding” makes sense when I think about it in the context of their lives. However, this leads to our intergenerational conflict of fending for your own family versus reserving supplies, like personal protective equipment (PPE), for those who need it. Many aunts in our family began stocking up on hospital masks, gloves, and gowns. I pleaded with them to donate whatever PPE we have to our local hospital and abide by current CDC recommendations, but they were set on doing what they felt was safest for their family. I did not push anymore because I empathize with their position. I could not blame them for wanting what is best for their loved ones, since they were experiencing much anxiety due to COVID-19. I began to worry about their mental and physical wellness, which may be triggering traumatic memories for them as it did my grandma. Thus, I confided in my cousin, Theresa, so we could work together to help our family through these unprecedented times.
Theresa’s Narrative
As a public health researcher, I closely follow press conferences, public health department guidance, epidemiological data, webinars, the works. One of my biggest concerns as a result of social distancing measures is how this would affect my older family members’ mental health. Currently, I do not have a direct role in the response to COVID-19; however, I have assumed the role of my family’s health advocate. This pandemic is a global traumatic event, which may lead to a spike in post-traumatic stress disorder (PTSD) as seen with 9/11 and Hurricane Katrina. These mental health consequences will also affect physical health. Reflecting on the experiences of the older family members who have experienced war, resettlement, violence, and uncertainty, I worry that COVID-19 will be another traumatic experience. In our family, mental health is not a normal topic of conversation and is often conveyed as feeling sad or anxious. One day, I decided to forward a viral handwashing video created by the Vietnamese Health Ministry to my family group chat. Not expecting much of a response, one of my aunts responded to me saying, “Thank you for sending such a fun song to help us learn how to wash our hands correctly. After watching this, I feel less anxious and more at peace. I still watch it once in a while to practice and keep my spirits up.” To me, this was an expression of anxiety; however, the group chat was able to serve as a platform to ease the effect of the current situation. While the group chat is helpful for social connection, many family members find it difficult to stay physically distant because of the close-knit nature of our family.
There is a lack of understanding among older family members regarding why we have to practice social distancing. Both of my parents are retired, but also in the high-risk category with several underlying health conditions. During mid-March, I had with my parents regarding their lack of compliance with social distancing precautions. I called home and told them, “Mom and Dad, we’re getting to that point where you need to stay home from church, the gym, and grocery stores. That means no visitors, too!” After an hour on the phone, my mom was a little more convinced about following the guidelines, but my dad still wanted to maintain business as usual, so he was upset with me. In my own anxious state, I called him again the next day. To my surprise, he told me he had canceled his trainer and client meetings–they would drop things off outside and not come in the house. While I was relieved, I began to reflect on the implications of social distancing for myself and my parents. I have not shared a meal with my parents in nearly 6 weeks, but instead, drop off groceries for them. It is interesting to see this reversal of roles. The younger generation is now taking care of the older generation, yet there is still some confusion regarding the safety measures that need to be taken. While I cannot physically visit my parents, we still stay in touch through Facebook video chats. Social media has been instrumental in keeping the family connected, but has also played a huge role in misinformation among family members and their friend networks.
Misinformation and deliberate display of political views within the group chats have created intergenerational conflict within the family. The second-generation young adults in our family are clearly not happy with the current administration; however, it is the opposite for the older family members despite the president’s anti-Asian rhetoric. The general discourse of our family group chats includes Eastern “cures” for COVID, non-FDA approved tests/treatments, and things the government has done “right.” One day, my dad called me and said, “Good news! President Trump said we have a cure for COVID.” I quickly looked through my sources for articles about treatments but the status was still the same–undergoing clinical trials. I asked him to send me what he was reading. Turns out, it was a chain message from friends on social media spreading incorrect news. With a new false sense of security, my parents are slowly starting to break the rules of social distancing by allowing extended family to visit them for virtual church services. I warned my mom that these actions are risky, but she told me, “God will save us.” In turn, I reminded her that we have to do our part to help God save us. In essence, the older generation’s inherent cultural and religious beliefs, combined with blind trust in their networks distort the messages that need to be heard.
Closing Thoughts
The COVID-19 pandemic has triggered memories of more fearful times in the history of our family, but has also given us an opportunity to respond through different roles. Though our family is physically distanced, we are all still present to offer social support. Despite the discord between generations, with issues ranging from personal safety to politics, we must view the situation from all angles. For Karen, it is a time when she is able to apply the medical knowledge she has gained thus far to help her family through this pandemic. This is a foreshadowing of the upcoming years, when she will be closer to home and able to serve the health needs of her family and local community. For Theresa, it is a time when she gets to step in to guide her family in filtering through the sheer amount of information presented in the media. These experiences have given her the opportunity to delve deeper into understanding effective health communication practices within the family context. Within each of our households, we are adapting to a new sense of normalcy, while outside our quarantine-cleaned doors, the world works to recover.