A Comparative Study of Hmong Women in Laos and Thailand

학위논문(석사) -- 서울대학교대학원 : 국제대학원 국제학과(국제지역학전공), 2022. 8. Eun Ki Soo.소수민족의 복잡성과 태국 또는 라오스 정부와의 관계는 소수민족 정책을 수립하는 발판의 역할을 한다. 소수민족 정책은 대개 개별 민족 집단을 발전시키고, 국가와의 관계를 형성하는 방편이 된다. 한편, 소수민족은 소수민족 정책을 통해 지속적인 발전에 필요한 영역을 맞닥뜨리게 된다. 소수민족의 발전을 위해, 소수민족은 주로 정부가 발표한 소수민족 정책을 채택하고 준수함으로써, 자신의 존재에 대한 인실을 높이기 위해 근본적인 요소들을 충족시키려고 노력한다. 이 요소들은 초등 및 중등 교육, 직업 교육과 훈련, 그로 인한 경제 활동 및 사회 참여 학습을 포함한 교육 전반을 포함한다. 흐몽족은 동남아시아의 소수민족정책을 통해 전례에 없던 반절을 이룬 대표적인 소수민족 집단이다. 특히 소수민족정책을 기반으로 교육발전이 이루어졌다. 독립 집단이자 소수민족인 흐몽족은 라오스, 태국, 베트남, 미얀마 등 동남아시아 산악지대로의 대규모 유입을 통해 확산됐다. 증가하는 한족 인구로 인해 18세기에 중국에서 동남아시아 국가들로 그들은 추방되었다. 그 후, 대규모의 흐몽족들이 태국으로 추방되었고, 또 다른 흐몽족 집단들은 깊은 밀림으로 탈출하여 자급자족을 하였다. 이러한 태국과 라오스에서 거주하고 있는 흐몽족의 정착 방식의 차이는 각 국가와의 관계형성, 또한 전반적인 발전, 교육 및 사회, 경제참여에 주도적인 요소가 되었다. 그리하여 실질적으로, 라오스와 태국의 흐몽족이 다양한 교육을 받을 수 있도록 국가 내 소수민족정책이 결정되었다. 라오스의 경우는 문해력, 초등교육, 취학률 증가 등에 기초교육 형태에 주안점을 두고 있다. 반대로, 태국 흐몽족 같은 경우 태국어를 구사하기 위한 전제조건으로 기초교육 보다는 직업 훈련, 생활기술, 농업, 노동 사회 참여 등 경제활동을 준비하는데 중점을 둔 교육이 집중되었다. 그럼에도 불구하고, 태국과 라오스 이 두 국가는 지속적인 공통의 어려움이 있었다. 라오스와 태국의 흐몽족은 각 국가 안에서 자신들의 발전과 자치를 위해 끊임없이 투쟁을 했다. 계급과 성별에 따라 분류된 사화의 일부인 흐몽적 여성들은 다른 차원의 차별과 투쟁에 직면하고 있다. 문맹, 성희롱, 노예화, 빈곤, 위험한 환경의 긴 역사는 부계사회 아래 흐몽족 여성들의 착취를 초래했다. 그들은 공동체적이고 가족 지향적인 사회에서 계층화에 의해 제약을 받아왔다. 흐몽족 내에서 남녀 학력과 교육성과의 격차를 줄이기 위한 방안으로, 흐몽 여성들이 교육을 받을 수 있는 기회가 정부가 세운 소수민족정책을 통해 주어졌다. 교육의 기화는 그들이 어느 정도의 성과를 낼 수 있도록 이끌어 주었고, 교육을 통해 경제활동과 사회참여에 전보다 적극적으로 임할 수 있게 되었다. 특히나, 소수민족 정책은 흐몽족 여성들이 문맹 퇴치, 초•중•고등교육, 직업학교 등 다양한 형태의 교육을 받을 수 있도록 주도했다. 교육을 받은 흐몽족 여성들은 집안 부계사회의 가족형태 안에서 자신의 의견을 표출 할 수 있게 되었다. 또한, 과거 흐몽 여성들의 의례적이고 전통적인 풍습인 가사 장려와 육아, 또는 배필을 조력하는 것에 모든 것을 전념하였다면, 교육의 기회와 달성으로 인해 흐몽족 여성들은 농촌과 도시지역에서 그들만의 사회공동체를 형성하여, 경제활동을 공유하고 지지해주는 관례를 쌓기도 한다. 태국 흐몽족 여성들은 자라면서 자신이 받지 못한 교육의 기회를 보상받듯이, 그들의 자녀들이 풍부한 인프라와 더 나은 학교 제도하에 제대로 교육을 받을 수 있도록 자발적으로 거주지를 옮기기도 한다. 또 다른 예로, 라오스의 흐몽족 여성들은 교육을 통해 습득한 기술과 지식을 경제활동에 활용함으로써 국가적 차원에서의 빈곤율을 완하는데 기여하였다.The complexity of minorities and their relationship with the Thai or Laotian government serve as a stepping stone in establishing minority policies. Ethnic minorities' policies are usually structured to develop individual ethnic groups and form relationships with the nation-state. Additionally, minorities face parts that need continuous development through minority policies. For the development of ethnic minorities, minorities usually try to meet fundamental factors to raise awareness of their existence by adopting and complying with the state-announced ethnic minority policies. The factors encompass basic education, including primary and secondary education, vocational education and training, economic activity, and social participation. The Hmong group is the representative ethnic minority group that has tremendously achieved unprecedented development through the ethnic minority policies in Southeast Asia. In particular, the development through education was made based on ethnic minority policies. The Hmong, an independent population, have been spread through large-scale influx into the mountainous regions of Southeast Asia, such as Laos, Thailand, Vietnam, and Myanmar. The mounting population of the Han Chinese expelled them from China out to the southeast Asian countries in the 18th century. Subsequently, thousands of Hmong were expatriated to Thailand, and other masses escaped to the deep jungle in Laos to live and shift for themselves. Such differences in settlement styles of the Hmong people living in Thailand and Laos have also been a leading factor in forming relationships with the state, overall development, and the beginning of education and social and economic participation. In particular, ethnic minorities policies in the country were resolved so the Hmong people in Laos and Thailand could receive divergent education. In the case of Laos, the main focuses of the educational forms were literacy skills, primary education, and an increase in the enrollment rate. On the contrary, in the case of the Thai Hmong people, education focused on preparing for economic activities such as vocational training, living skills, agriculture, labor, and social participation rather than emphasizing basic education as a given prerequisite for speaking Thai. Nevertheless, there was a common difficulty that persisted. The Hmong in Laos and Thailand faced a constant conflict for their development and autonomy against the national state. Hmong women, part of a society classified by class and gender, face different levels of discrimination and struggles. The long history of illiteracy, sexual harassment, enslavement, poverty, and a hazardous environment has led to the exploitation of Hmong women under the paternal community. They are constrained by social stratification in a communal and family-oriented society. As a way to narrow the gap between men’s and women’s educational levels and attainment within the Hmong group, the opportunity for Hmong women to receive an education was given through the ethnic minorities policies established by the national government. The educational opportunities led them to a certain degree of attainment, including eradicating illiteracy, primary and secondary education, and vocational schools. These allowed them to be involved in economic activities and social participation. As a result, the educated Hmong women have become able to express their opinions to male figures within the form of the paternal society of the family. In addition, if the traditional and ritualistic customs of Hmong women of the past were devoted to encouraging housework, child raising, and submitting to their husbands for their own contentment, Hmong women grew to form their own social communities in rural and urban areas to share and support economic activities. Just as though Hmong women were compensated for the opportunity of education they had not received while they grew up, Thai Hmong women voluntarily moved their residences to ensure that their children received proper education under abundant infrastructure and better school systems. As another example, Hmong women in Laos contributed to alleviating the poverty rate on a national scope by utilizing skills and knowledge acquired through education in economic activities.Abstract iii List of Figures vii List of Tables vii Chapter 1. Introduction 1 1.1 Historical Background 3 1.2 Research Methodology 4 Chapter 2. Literature Review 5 2.1. Mông or H'Mông in Laos 6 2.2. Meo “hill tribes” in Thailand 7 2.3. Hmong women in Laos 9 2.4. Hmong women in Thailand 10 2.5. Common roles of Hmong women 11 Chapter 3. Policies on Ethnic Minorities/Hill Tribes 14 3.1. Policies on Ethnic Minority: Hmong in Laos 14 3.2. Policies on Hill Tribes: Meo in Thailand 20 Chapter 4. Policy Outcomes 28 4.1. Hmong women’s education and poverty reduction– Laos 28 4.2. Meo women’s education and economic activity –Thailand 40 Chapter 5. Conclusion 51 Bibliography 54 국문초록 59석

구척수근위축증에서 감각신경병의 단면적 및 종적 연구

Objectives: Bulbo-spinal muscular atrophy (BSMA) is an inherited motor neuronopathy, but it is known that subclinical sensory neuropathy can be found. The objective of this study is to clarify the features of sensory neuropathy by cross-sectional and longitudinal studies. Method: We analyzed the clinical and electrodiagnostic data of 41 BSMA patients who were genetically confirmed. Follow-up studies were performed in 10 patients among them. Results: Of 41 patients, 11 complained of sensory symptoms (26.8%), such as numbness or paresthesia of distal extremities. However, sensory neuropathy was observed in 23 patients (56.1%) with nerve conduction study (NCS). Reduced amplitude of action potentials was the most remarkable finding of the group with sensory neuropathy. For 10 patients with follow-up NCS, the mean follow-up interval was 8 years. There was no significant temporal change between the first and the follow-up sensory NCS. Conclusion: Subclinical sensory neuropathy was found in 56.1% of BSMA patients. The longitudinal study shows that subclinical sensory neuropathy in BSMA may not progress over time.ope

Myelin Protein Zero (MPZ ) Gene Analysis in Korean Patients with Charcot-Marie-Tooth - Clinical and Electrophysiological Characteristics -

Background: Mutations in the myelin protein zero (MPZ) gene, which is located on chromosome 1q21-q22, is present in Charcot-Marie-Tooth disease type 1B (CMT1B), CMT type 2, Dejerine-Sottas syndrome, and congenital hypomyelination neuropathy. It is proposed that the nature and position of the MPZ mutations mainly determine the axonal and demyelinating phenotypes. In this study, we investigated to determine the clinical and electrophysiological characteristics in CMT patients with mutations in the MPZ gene. Methods: We examined mutations of MPZ, in 62 Korean families diagnosed as having CMT disease. Mutations were confirmed by through both strands sequencing. Nerve conduction studies were carried out in CMT patients having each mutation. Results: The three mutations (Asp118Asn, c.449-1G>T (3´-splice site), Lys236Glu), determined to be novel, were not detected in the 105 healthy controls. The mutation frequency of MPZ was similar as those found in several European populations. Electrophysiologically, 3´-splice site mutation (449-1G>T) showed the conduction block and moderate slowing nerve conduction velocities like that of CMT1B. However, the other mutations represented the electrophysiological features of CMT type 2. Conclusions: We report the identified three novel MPZ mutations in Korean CMT patients and the phenotype-genotype correlations based on nerve conduction studies.ope

항 Signal Recognition Particle (신호인식입자) 항체와 연관된 근병증

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A Novel V136A Mutation in Cx32 and a R359W Mutation in EGR2 within a Charcot-Marie-Tooth Patient

Mutations of the CMT genes develop a variety of distinct phenotypes. Cx32 gene mutations cause the X-linked form of CMT disease, and mutations in EGR2 are associated with CMT type 1, DSS, and congenital hypomyelination neuropathy. Her parents, grandmother and sister did not show the V136A mutation in Cx32. We report the first CMT patient with EGR2 and Cx32 mutations.ope

Electrodiagnosis vs. Pathology II: Nerve

Although electrophysiological study (Nerve Conduction Studies/EMG) is among the most sensitive and reliable approaches to detect and to characterize certain aspects of nerves disease, it is important for physicians to appreciates that EMG has limited value in (1) inferring symptoms and neuropathic deficit, (2) inferring involvement of small diameter fiber, (3) inferring underlying biochemical or other pathophysiological derangement, (4) inferring the presence and type and pathologic alteration in single fibers or Schwann cell, or (5) inferring interstitial pathologic abnormalities. For these purpose, an adequate neurological history taking and examination, delicate histologic study of nerve, quantitative autonomic test, and a variety of laboratory examination are usually needed. The purpose of this article is not to diminish EMG or to elevate the procedure of nerve biopsy, rather to provide a conceptual framework for how these techniques and the clinical and laboratory examinations can be used together in the assessment and follow up of neuropathy.ope

Diagnosis and Treatment of Neuropathic Pain

Since the earliest descriptions of pain related to injury of the nervous system, it has been recognized that the characteristics of this type of pain differ markedly from those of pain due to nonneural tissue damage. Later as new analgesics were developed, it became clear that neurogenic pain was very often refractory to these drugs. Recently neuropathic pain is defined as "pain initiated or caused by a primary lesion or dysfunction in the nervous system." Inflammatory reaction and neuropathic pain are often considered to be distinct entities. The development of neuropathic pain involves not only neuron but also inflammatory cells, chemokines, and glial cells. Treatment of neuropathic pain is difficult and frequently unrewarding. The basic principles are (1)the identification and elimination of the underlying pathologic mechanism that maintains central sensitization; (2)the use of nonsteroidal anti-inflammatory drugs to reduce peripheral sensitization and modulate the activity of nociceptors; (3)the use of tricyclic antidepressants to induce sleep and decrease lancinating and burning neuropathic pain; (4)a trial of gabapentin, pregabalin, lamotrigine and topamax; (5)the use of lidocaine patch for intractable trigeminal neuralgia; (6)sympathetic blockade for complex regional pain syndrome while patients are stick sympathetically maintained; (7)dorsal column stimulation; (8)intrathecal therapies including morphine, clonidine, and GABAB agonists when other less invasive therapies have failed. In this article we reviewed the role of peripheral inflammation for development of neuropathic pain, diagnosis, and new opportunities for treatment of neuropathic pain, especially focused on medical treatments with antiepileptics and antidepressantsope

Evaluating an In-House Cell-Based Assay for Detecting Antibodies Against Muscle-Specific Tyrosine Kinase in Myasthenia Gravis

Background and purpose: Detecting antibodies against muscle-specific tyrosine kinase (MuSK Abs) is essential for diagnosing myasthenia gravis (MG). We applied an in-house cell-based assay (CBA) to detect MuSK Abs. Methods: A stable cell line was generated using a lentiviral vector, which allowed the expression of MuSK tagged with green fluorescent protein in human embryonic kidney 293 (HEK293) cells. Serum and anti-human IgG antibody conjugated with red fluorescence were added. The presence of MuSK Abs was determined based on the fluorescence intensity and their colocalization in fluorescence microscopy. Totals of 218 serum samples collected from 177 patients with MG, 31 with other neuromuscular diseases, and 10 healthy controls were analyzed. The CBA results were compared with those of a radioimmunoprecipitation assay (RIPA) and an enzyme-linked immunosorbent assay (ELISA). Results: The MuSK-HEK293 cell line stably expressed MuSK protein. The CBA detected MuSK Abs in 34 (19.2%) of 177 samples obtained from patients with MG and in none of the participants having other neuromuscular diseases or in the healthy controls. The clinical characteristics of the patients with MuSK MG determined based on the CBA were strongly correlated with known clinical features of MuSK MG. There was an almost perfect agreement between the results of the CBA and those of the RIPA (Cohen's kappa=0.880, p<0.001) and ELISA (Cohen's kappa=0.982, p<0.001). Conclusions: The results of the in-house CBA showed excellent agreement with both the RIPA and ELISA. Our in-house CBA can be considered a reliable method for detecting MuSK Abs.ope

Focal Calf Muscle Hypertrophy after Peripheral Nerve Injury

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Clinical and Electrophysiological Characteristics of Leprous Neuropathy

Background: The medial vestibular nucleus is the largest one among the vestibular nuclei and known to play important roles not only in normal vestibular information processing but also in vestibular compensation. Glutamate is known to have a key role in vestibular compensation via long term potentiation and depression. But the action of nitric oxide related with glutamate is poorly studied. This experiment was designed to explore the effects of nitric oxide on the neuronal activity of a rat medial vestibular nuclear neuron using a nitric oxide enhancing drug, S-nitroso-N-acetylpenicillamine (SNAP). Methods: Experiments were carried out on Sprague-Dawley rats aged 14 to 17 days. Neurons of MVN were obtained via enzymatic dissociation of a microtomized rat brainstem. Whole-cell membrane potentials were recorded at room temperature by using standard patch-clamp techniques. Action potentials were obtained after administration of SNAP. Changes of potassium currents were recorded using SNAP and ODQ (1H-[1, 2, 4] oxadiazolo [4, 3-a] quinozalin-1-one), an inhibitor of guanylyl cyclase. Results: The mean spike frequency of action potentials was increased by adding SNAP. The mean amplitude of afterhyperpolarization was decreased by adding SNAP. The mean potassium current of medial vestibular nuclear neurons was decreased by SNAP. ODQ inhibited the SNAP-induced potassium currents. Conclusions: These results suggest that nitric oxide increases the neuronal activity of rat medial vestibular nuclear neurons by inhibiting potassium currents via a cGMP dependent mechanism. KeyWords:S-nitroso-N-acetylpenicillamine, Nitric oxide, Medial vestibular nucleus, Action potentialope