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Cultural Approaches to Pediatric Palliative Care in Central Massachusetts: Burmese

This subject guide is a collaborative project with the Children's Medical Center Pediatric Palliative Care Team, the Lamar Soutter Library, and Interpreter Services.




Geography: Burma is located in southeastern Asia, bordering the Andaman Sea and Bay of Bengal, between Bangladesh and Thailand. There is industrial pollution of air, soil, and water. Sanitation is a problem and poor water treatment contributes to disease. (CIA)

General Culture Information: The country's culture, heavily influenced by neighbors, is based on Theravada Buddhism intertwined with local elements. Burma's diverse population has played a major role in defining its politics, history and demographics in modern times, and the country continues to struggle to mend its ethnic tensions. A diverse range of indigenous cultures exist in Burma, the majority culture are primarily Buddhist and Bamar. Bamar culture has been influenced by the cultures of neighboring countries. Burmese, the mother tongue of the Burma, is related to Tibetan and to the Chinese languages. The Burmese Independence day is celebrated on January 4th. Other holidays are primarily Buddhist.

Local Community Information: The Burmese communities in Massachusetts celebrate their heritage in festivals and other community events.  “Because their numbers in the United States are so small, Burmese Americans tend not to settle in large groups, but maintain contact with other Burmese Americans in a fairly large geographical region. They may travel several hours to gather with people in their geographical area for celebrations at a Theravada Buddhist monastery, also called a pongyi-gyuan.” (Cooper, Amy)

Family Structure: Usually a Burman family has about five children. The family also consists of grandparents and the extended family members. Under Buddhism there is no limitation on the number of spouses one can have at the same time. A person can marry as many women or men as they want to, although this practice is rare today. Parents, Grandparents help the young couple take care of any babies that are born. Family is very important in this culture and it is very important to honor and respect the elders. There are specific ways in addressing those that are respected.  Employment in professional areas of academia, business and technical work seems to be the concentration of Burmese Americans.

Religious Practice: Buddhism is the religious practice that affects Burmese culture and civilization. This was discovered by Siddhartha Gautama, the Buddha. There are two classes of Buddhism 1) Theravada (The school of the Elders), which is practiced in Burma, and much of east Asia. 2) Mahayana (The Great Vehicle), which is practiced mainly in Sri Lanka and Southeast Asia.

“Buddhism is a non-theistic religion that claims that suffering is unavoidable, and that the root of suffering is attachment, greed and desire. Freedom from suffering can be obtained by following what is known as the Noble Eightfold Path: Right Understanding, Right Thought, Right Speech, Right Action, Right Livelihood, Right Effort, Right Mindfulness, and Right Concentration. Buddha's teachings are known as the Dharma, and they are given to a collective body of followers or a religious community called the Sangha. Buddhists strive to follow the Five Precepts: not to take life, not to steal, not to commit adultery, not to tell lies, and not to take intoxicating drinks. They also pledge to take refuge in the "Three Jewels:" the Buddha, the Dharma and the Sangha.” (Countries and their Cultures)

Food in Daily Life: The staple of the Burman diet is usually rice, eaten with a lot of curry (but not as much as in Indian food), garlic, and ginger. Fish sauce and dried shrimp are used for flavor. Ngapi, a stong-flavored pickled-fish paste, is eaten at almost every meal. Burman do not eat meat in large quantities. Meat is usually cut into small pieces and fried with oil. Onions, garlic, and spices such as curry and salt are mixed and slowly cooked. The two most common Burman dishes are Mohinga (slightly fermented rice noodles mixed in a thick, fish soup) and Ohnnukhaukswa, a chicken stew cooked in coconut milk, also served with noodles. Under ripe mangoes and limes are typically served with meals. Burman eat hot, sour, sweet, salty, bitter, and spicy snacks. The Burman commonly eat with their fingers. Green tea is one of the most common drinks, next to water. Alcohol is frowned upon and very few people drink it regularly. Burmese usually eat a morning meal and an evening, before dark.

Communication Style: Language: Most Burmese are bilingual, speaking Burmese and English.

The Burmese are very sociable people; it is inappropriate to lose one’s temper or show a lot of emotion in public. The head is spiritually considered to be the highest part of the body therefore Burmese and other Buddhists follow the custom of not touching a person on the head.  Patting a child on the head is considered dangerous to a child’s well being. A person should not point the feet at anyone. Foot wear is taken off when entering buildings for religious reasons and also removed when entering a house.

Young children are given a lot of attention by adults, even to those children who are not their own. Newborns are placed in carefully made cradles and carried on the hip or held in a sling on their mother’s back. Young children are coddled, able to move about freely and allowed to handle items that catch their attention. Weaning usually occurs when a child is two or three years old. And relatives or friends may nurse an infant. When a child is a few years old a ceremony is held to give the child a name.

Health and Wellness: The practice of traditional forms of medicine continues to be important mostly among ethnic minorities. But because of the aging of the traditional healers, traditional remedies and practices are being lost. There are very serious health problems rising including Malaria, AIDS, and malnutrition. There are very poor facilities of healthcare due to inadequate funding and medical training.

Death and Afterlife: Buddhists believe in the concept of rebirth, and this cycle of death and rebirth ends when one reaches wisdom and lack of desire. The bodies are either buried of cremated. During the funeral, monks and mourners carry the coffin chanting prayers all the ways to the cemetery or crematorium. The ceremonies are performed in accordance to the manner of death; violent deaths tend to have a quicker burial, because it’s believed that their spirits are lingering.


The World Fact Book.  Retrieved from

Burmese Community Activities and Events.  Retrieved from  

Countries and their Cultures:  Burmese Americans.  Retrieved from