Search

International audience; Numerous works in health anthropology have highlighted the use of medicinal plants (herbal tea, poultice, etc.) by the Hmong who migrated from Laos to the United States from the end of the 1970s and during the 1980s. These uses by Hmong Americans, often combined with western medicine, are reinforced through the circulation of family advice from Laos. The medicinal plants available in the US are cultivated from domestic gardens, imported dried from northern Laos, or brought directly by Hmong therapists travelling from Laos. The objective of this contribution is to highlight the ways medicinal plants, traditional therapists, and the mountainous landscapes of northern Laos, work together to produce hybrid territories and identities, creating therapeutic experiences for the Hmong living in United States; De nombreux travaux réalisés en anthropologie de la santé ont mis en évidence la perpétuation de l’usage de plantes médicinales sous des formes diverses (tisane, cataplasme, etc.) au sein de la diaspora hmong ayant migré aux États-Unis à partir de la fin des années 1970 et au cours des années 1980. Ces usages, le plus souvent combinés à des traitements biomédicaux, circulent sous la forme de conseils familiaux transmis au sein du foyer ou de la famille élargie dans le territoire d’accueil. Les plantes médicinales utilisées proviennent soit de plantations réalisées dans des jardins domestiques autour des maisons, soit sont importées sous forme séchée depuis le nord du Laos, soit apportées directement par des thérapeutes hmong voyageant du Laos. L’objectif de cette contribution est de mettre en évidence la manière dont les plantes, les figures des thérapeutes traditionnels et les paysages de montagne du nord du Laos participent à la construction d’ancrages territoriaux et identitaires hybrides et ouvrent des perspectives thérapeutiques bénéfiques pour la diaspora hmong aux États-Unis.

Background In Lao PDR, the Hmong ethnic group has extensive knowledge about the use of medicinal plants. However, despite the importance of the Hmong pharmacopeia as a primary health care resource, no study has been undertaken to thoroughly document medicinal plant knowledge and its transmission. Objectives of this study are (i) to describe and characterize Hmong pharmacopeia, and (ii) to understand how medicinal plant knowledge is transmitted and spread among Hmong in Lao PDR, in order to assess whether this knowledge base is under threat. Methods In order to describe Hmong pharmacopeia, a total of 14 interlocutors were interviewed in three provinces (Bokeo, Xieng Khouang, and Vientiane), using “walk in the wood” methodology. To gain insight about knowledge transmission, semi-structured interviews were conducted with 28 people. Twenty of them were herbalists. Data analysis was performed using univariate analysis for the description of the pharmacopeia. Medicinal plant knowledge consistency was assessed through use and plant name overlapping. Answers to the semi-structured interview on knowledge transmission were analyzed qualitatively. Results Three hundred thirty-three different medicinal species were collected. The majority of uses attributed to plants were gastrointestinal conditions (22% of total use reports), gynecological conditions and sexually transmitted disease (12%), skin affections (8%), kidney and bladder problems (5%), physical traumas (5%), and aphrodisiac (or male tonics; 5%). Use convergences are more marked in the gynecological sphere, but there is a strong heterogeneity in practices and knowledge. Medicinal plant knowledge transmission is oral, gained from direct experience since childhood, matrilineal, and kept strictly within the family lineage. Apparent limited consensus on uses might stem from the method of knowledge transmission and to the economic value given to medicinal plants. Discussion Use pattern of species from the Hmong pharmacopeia does not appear to be strikingly different from the national Lao pharmacopeia. Differences may lie in the methods and reasons for knowledge transmission. It can be proposed that the economic value given to plants helps in keeping the knowledge alive, and encourages its transmission. Conclusion Hmong traditional medicine is constantly evolving in a dynamic process and aims to respond to health problems faced by the local population. Herbalists appear as health fully fledged actors and should be recognized and valued as such. Electronic supplementary material The online version of this article (10.1186/s13002-019-0307-2) contains supplementary material, which is available to authorized users.

International audience; In this paper, we are exploring the current reorganisation of the Lao-Thai border area through the study of the therapeutic behaviours of individuals. We are focusing on the mobility of Laotian patients towards the neighbouring Thai hospitals. This practice of some border inhabitants can occur with the recent opening of Laos and it also emphasizes the development gap between the two countries.These patients’ flows are relevant indicators to describe and explain the socio-territorial processes currently at work within the Lao-Thai area. This approach using health determinants allows studying the various characteristics of a border: political, economic, social, cultural and medical. A disease does not only affect an individual in his biological body but it also has an impact on his family, his community, therapists, public health institutions as well as administrative and political institutions. Therefore, this approach offers us to embark in a new debate on the border.The Lao-Thai border area is complex; on the one hand, we observe the gradual weakening of the border though the practices of patients; and, on the other hand, its continuation is reaffirmed by statements of some political leaders and hospital officials on both sides.; Nous proposons d’explorer la recomposition actuelle de l’espace frontalier lao-thaïlandais à travers les comportements thérapeutiques des individus, et plus particulièrement le recours aux soins des Laotiens dans les hôpitaux thaïlandais limitrophes, appelés par commodité les recours transfrontaliers. Cette pratique d’une partie de la population vivant dans les bordures frontalières accompagne l’ouverture récente du Laos et souligne l’écart de développement existant entre les deux pays.Les recours aux soins transfrontaliers sont des indicateurs pertinents pour décrire et expliquer les processus socio-territoriaux actuellement à l’œuvre au sein de l’espace lao-thaïlandais. L’approche par les soins présente l’intérêt d’aborder la frontière sous tous ses aspects : politique, économique, sociale, culturelle et sanitaire. La maladie ne concerne en effet pas seulement l’individu affecté dans son corps biologique, mais également sa famille, sa communauté, les thérapeutes, les institutions publiques de santé ainsi que les institutions administratives et politiques. L’approche sanitaire privilégiée dans cette contribution donne ainsi la possibilité de renouveler la réflexion sur la frontière.Entre l’effacement progressif de la frontière dans les pratiques des patients et son maintien réaffirmé par certaines déclarations des dirigeants politiques et des responsables hospitaliers, l’espace lao-thaïlandais s’avère complexe ; les fonctions, tant de coupure que de couture, de la frontière sont tour à tour invoquées voire instrumentalisées suivant les intérêts propres à chacun.