This information is to be used as a guide and is not intended to describe all members of the community. There will be cultural differences between people belonging to different regions, religions and social groups, as well as between individuals within any culture.
Burmese food and cultural profile: dietetic consultation guide
1. Booking a client appointment
Key considerations⢠Interpreters: Few people born in Burma speak English proficiently, so it is likely an interpreter will be required. Burmese is the most common
language of Myanmar (Burma); however, there are many other languages spoken, including Karen languages, Karenni, Chin languages and Rohingya. You will need to organise an interpreter appropriate to the clientâs ethnicity, but be aware that you may need a telephone interpreter, as local interpreters in many of these languages may not be available.
⢠It may be useful for women to attend their husbandsâ appointments, as they are usually the primary cooks.
⢠Traditionally, people from Burma do not have family names. Therefore, all members of a family may have names that bear no obvious relationship to each other.1
2. Preparation for the consultationWorking with an interpreterIt is important that a trained and registered interpreter is used when required. The use of children, other family members or friends is not advisable. Health services must consider the potential legal consequences of adverse outcomes when using unaccredited people to âinterpretâ if an accredited interpreter is able to be sourced.
If you have limited experience working with an interpreter, it is recommended that you improve these skills prior to the appointment. There are many online orientation courses available and Queensland Health has produced guidelines for working with interpreters that can be accessed here.
This resource is a guide for dietitian/nutritionists to provide culturally appropriate and effective services to community members from Burmaâs many and varied ethnic groups. It follows the ADIME format and provides information about the food and food practices of people from Burma (also known as Myanmar or The Republic of the Union of Myanmar) who have settled in Brisbane (Australia).
The profile follows the chronological steps in individual case management.
These include: 1. Booking a client appointment 2. Preparation for the consultation 3. Assessment 4. Diagnosis 5. Intervention 6. Monitoring and evaluation
Burma
Putao
Shingbwiyang
MawlaikKalemyo
Hakha
Bhamo
Lashio
Mandalay
Keng TungLoi-lem
Loikaw
Taungoo
Bago
MudonRANGOON
LawksawkChauk
Magway
Kyaukpyu Nay Pyi Taw
Pathein
Ye
Myeik
Dawei
Kawthaung
This information is to be used as a guide and is not intended to describe all members of the community. There will be cultural differences between people belonging to different regions, religions and social groups, as well as between individuals within any culture.
2 Burmeseâfoodâandâculturalâprofile:âdieteticâconsultationâguide
TraditionalâgreetingsâandâetiquetteGivenâthereâareâaâlargeânumberâofâethnicâgroupsâandâcorrespondingâlanguages,âmakeâsureâtoâcheckâwithâtheâinterpreterâwhatâtheâappropriateâgreetingâwouldâbeâpriorâtoâtheâconsultation.â
Aâfriendly,âprofessionalâapproachâisâexpectedâfromâhealthâprofessionals,âsuchâasâshakingâhandsâtoâgreetâtheâclientâandâusingâtitles,âsuchâasâMrâandâMrsâtoâaddressâadults.â
TheâfollowingâetiquetteâisâparticularlyâimportantâforâBurmeseâBuddhists:â1
â˘â âItâisâdisrespectfulâforâlegsâtoâbeâstretchedâoutâwithâfeetâpointedâtowardsâaâperson.â˘â âTheâheadâisâconsideredâtheâspirituallyâhighestâpartâofâtheâbody,âandâsensitivityâisâadvisedâifâitâisânecessaryâtoâtouchâtheâhead.â˘â âItâisâconsideredâpoliteâtoâgiveâthingsâ(food,âanâappointmentâcard,âdietâsheet)âtoâothers,âwithâtwoâhandsâratherâthanâjustâone.â
TheseâadditionalâpointsâofâetiquetteâareârelevantâforâKarenâpeople:1
â˘â âKarenâpeopleânormallyâwalkâbehindâthoseâwhoâareâtheirâseniorsâandâelders.â˘â âKarenâpeopleâmayâanswerâaâquestionâwithâânoââtoâbeâmodestâwhenâanâaffirmativeâanswerâmayâseemâmoreâappropriate.â˘â âDoânotâgoâintoâtheâbedroomâorâkitchenâofâaâKarenâhomeâunlessâyouâareâspecificallyâinvited.2
â˘â âTakeâyourâshoesâoffâbeforeâenteringâaâKarenâhome,âevenâifâyouâareâtoldâotherwise.2
ItâisâoftenânotâappropriateâtoâestablishâdirectâeyeâcontactâwithâChinâpeople,âespeciallyâolderâcommunityâmembers.1
English BurmeseâPronunciation
Helloâ(formal/polite) Min-ga-la-baâshinâ(saidâbyâaâwoman)
Min-ga-la-baâcam-yahâ(saidâbyâaâman)
Thankâyou Chay-zoo-tin-bah-dey
Goodbye Ta-taâ(informal)
Background
Ethnicity Thereâareâoverâ135âethnicâgroupsâinâBurma.3âTheâlargestâethnicâgroupâisâBurmansâorâBamar,âwhoâmakeâupâaroundâ68%âofâtheâpopulation.1âOtherâethnicâgroupsâareâShanâ(9%),âKarenâorâKayinâ(7%),âRakhineâ(4%),âChineseâ(3%),âMonâ(2%),âandâotherâgroupsâincludingâChin,âKachin,âIndianâandâKayahâorâKarenniâmakeâupâ5%.1
ItâisâworthânotingâthatâwhileâpeopleâmightâbeâbornâinâBurma,âtheyâdonâtânecessarilyâidentifyâasââBurmeseâ,âratherâtheyâwillâidentifyâwithâtheirâethnicâgroup.
Religion Buddhistâ89%,âChristianâ4%,âMuslimâ4%,âAnimistâ1%,âotherâ2%.4âApproximatelyâ70%âofâKarenâpeopleâareâTheravadaâBuddhist,âBuddhist-AnimistâorâAnimist,âandâtheâremainderâareâChristian.1âTheâKarenniâpeopleâareâmostlyâAnimist.1âTheâRohingyanâBurmeseâareâpredominantlyâMuslim.1
Language Thereâareâaroundâ100âdifferentâlanguagesâspokenâinâBurma.5âBurmeseâisâtheâmostâcommonâlanguageâofâtheâcountry;âothersâincludeâKaren,âShan,âKachin,âChin,âMonâandâKarenniâlanguages.5â
Historyâofâconflict6,7,8
TheâMyanmarâpopulationâisâethnicallyâcomplex,âwithâaâlongâhistoryâofâconflictâbetweenâdifferentâethnicâgroups.âTheâindigenousâpeopleâareâtheâKaren.âHistorically,âvariousâpopulationsâhaveâsettledâorâinvadedâtheâcountry,âandâMyanmarâhasâbeenâruledâinâpartâbyâtheâMon,âtheâBurmans,âtheâMongolsâandâtheâShan.âInâtheâ18thâcentury,âtheâcountryâbecameâpartâofâBritishâIndia.âDuringâtheâSecondâWorldâWar,âtheâJapaneseâinvadedâtheâcountryâandâaâBurmeseâarmyâwasâformedâandâjoinedâforcesâwithâtheâBritishâtoâexpelâtheâJapanese.âIndependenceâfromâtheâBritishâwasâachievedâinâ1948.âDespiteâdemocraticâparliamentaryârule,âyearsâofâinternalâconflictâfollowed.âMilitaryâruleâfromâ1962â2011,âwhichârepressedâallâdemocraticâoppositionâandâsuppressedâethnicâminorityâgroups,âgaveâwayâtoâanâarmy-ledâtransitionâtoârepresentativeâgovernment.âCeasefireâdealsâbetweenâtheâgovernmentâandârebelâethnicâgroupsâwereâsignedâinâ2011âandâ2012,âandâagainâinâMarchâ2015,âwithâvaryingâdegreesâofâsuccess.âTensionsâbetweenâallâgroupsâremain.
This information is to be used as a guide and is not intended to describe all members of the community. There will be cultural differences between people belonging to different regions, religions and social groups, as well as between individuals within any culture.
3Burmeseâfoodâandâculturalâprofile:âdieteticâconsultationâguide
Migrationâhistory OverâaâmillionâpeopleâfromâaâvarietyâofâethnicâgroupsâhaveâbeenâdisplacedâfromâtheirâhomesâinâBurma.7âManyâhaveâspentâyearsâinârefugeeâcampsâonâtheâborderâofâThailandâbeforeâmigratingâtoâAustralia.7âOtherâcountriesâofâtransitionâareâIndia,âBangladeshâandâMalaysia.1â
Genderârolesâ BothâmenâandâwomenâorâolderâchildrenâmayâbeâinvolvedâinâtheâpreparationâofâfoodâandâshoppingâinâbothâBurmaâandâAustralia.âMenâmayâcookâmoreâforâlargeâgatheringsâandâareâmoreâlikelyâtoâcookâmeat.
Householdâsize AccordingâtoâMyanmarâsâ2014âcensus,âtheâaverageâhouseholdâsizeâwasâ4.4âpeople.9âInâtheâKachinâStateâandâChinâState,âtheâaverageâwasâ5.1âpeopleâperâhousehold.9âSeventyâperâcentâofâtheâpopulationâliveâinâruralâareas.9
PopulationâinâAustralia
Atâtheâtimeâofâtheâ2011âAustralianâcensus,âthereâwereâ21,760âBurmese-bornâpeopleâlivingâinâAustralia,âwithâ1,897âresidingâinâQueenslandâandâapproximatelyâ1,471âinâBrisbane.10
HealthâprofileâinâAustralia
Lifeâexpectancy InâBurma,âlifeâexpectancyâisâ63.9âyearsâforâmalesâandâ69.9âyearsâforâfemales.9âLifeâexpectancyâisâhigherâinâurbanâareasâ(72.1âyears)âthanâinâruralâareasâ(65.5âyears).9âNoâinformationâisâavailableâonâlifeâexpectancyâforâBurmese-bornâpeopleâinâAustralia.
Newâarrivals BurmeseârefugeesâsettlingâinâAustraliaâhaveâbeenâshownâtoâsufferâfromâvitaminâDâdeficiencyâandâhighâratesâofâtreatableâinfectiousâdiseases,âincludingâHelicobacter pyloriâinfectionâ(implicatedâinâcausingâgastricâulcers),âlatentâtuberculosisâandâstrongyloidiasisâ(aâchronic,âparasiticâinfectionâthatâcanâcauseâgastrointestinalâsymptomsâsuchâasâpain,âbloating,âconstipationâandâdiarrhoea).11
Chronicâdisease RefugeesâfromâThai-Burmeseâborderâcampsâmayâsufferâfrom,âorâbeâatâriskâof,âdepressionâandâpost-traumaticâstressâdisorderâ(PTSD).âSomeâBurmeseâcommunityâmembersâinâBrisbaneâreportâanâincreasedâriskâofâdiabetes,âhighâbloodâpressureâandâweightâgainâassociatedâwithâanâincreasedâlengthâofâstayâinâAustralia.
Oralâhealth RefugeesâfromâBurmaâareâunlikelyâtoâhaveâhadâaccessâtoâoralâhealthâservicesâinâtheirâownâcountryâandâmayânotâseeâoralâhealthâasâaâpriority.âIncreasedâaccessâtoâandâconsumptionâofâsugaryâdrinksâandâsnackâfoodsâinâAustraliaâwillâfurtherâimpactâonâtheirâoralâhealth.
Socialâdeterminantsâofâhealthâandâotherâinfluences
ClientsâfromâBurmaâmayâpresentâwithâvastâdifferencesâinâsocialâcircumstancesâ(educationâlevelsâandâincome),âreflectingâdifferentâethnicâbackgrounds,âtransitionâexperiencesâandâlengthâofâstayâinâAustralia.âInâgeneral,ânewlyâarrivedârefugeesâareâlikelyâtoâbeâonâaâlowâincome,âandâlevelsâofâformalâeducationâwillâvary.â
Backgroundâââcontinued
This information is to be used as a guide and is not intended to describe all members of the community. There will be cultural differences between people belonging to different regions, religions and social groups, as well as between individuals within any culture.
4 Burmeseâfoodâandâculturalâprofile:âdieteticâconsultationâguide
Traditionalâfoodâandâfoodâpractices
Religious and cultural influencesThereâareâregionalâandâreligiousâvariationsâinâfoodâconsumedâdueâtoâtheâwideâvarietyâofâethnicâgroupsâthatâliveâinâBurma.âForâexample,âtheâMuslimâRohingyanâpeopleâeatâmuchâmoreâfish,âseafoodâandâchilli.âTheyâalsoâobserveâRamadan,âlikeâotherâMuslimsâaroundâtheâworld.âChin/ZomiâpeopleâinâBrisbaneâreportâeatingâaâtypeâofâfermentedâmeatâsausage,âandâKarenniâpeopleâinâBrisbaneâreportâeatingâmanyâdifferentâtypesâofâfermentedâvegetablesâandâchewingâbeetleânutâinâBurma.
Traditional meals and snacks
Breakfast InâBurma,âpeopleâmayâeatâtoastâorânoodlesâatâbreakfastâandâmayânotâcountâthisâasâaââmealâ.â(Thisâmayâbeâinâadditionâtoâtheâtwoâmealsâperâdayâreportedâbelow.)
Mainâandâotherâmeals
Mostâethnicâgroupsâeatâsimilarâdishesâofâriceâandâcurry,âusuallyâservedâwithâaâsoup,âsaladâand/orâstir-fry,âwithâvariationsâinâmeatâandâavailableâvegetables.
TheâKarenâpeopleâtraditionallyâeatâtwoâmealsâofâcurryâandâriceâperâday,âandâtheâsecondâmealâisâtheâmainâmeal.âEldersâareâservedâfirst;âthenâtheâfather,âfollowedâbyâtheâchildren.âMonosodiumâglutamateâmayâbeâusedâinâcooking.
Mainâandâotherâmealsâââcontinued
Eatingâpractices:âInâruralâareas,âpeopleâeatâaroundâaâcommunalâpot,âusingâtheirâfingers,âandâitâisârareâtoâseeâaâforkâorâspoon.âInâotherâareas,âspoonsâareâtheâmostâcommonâutensils.âInâurbanâareas,âpeopleâeatâatâaâtableâusingâplatesâandâbowls,âandâcommunalâfoodâisâplacedâinâtheâmiddleâofâtheâtable.
Karenniâpeopleâreportâtheâmorningâandâeveningâmealâasâtheâbiggestâmealsâofâtheâday.âPeopleâdoingâmanualâlabour,âsuchâasâfarmers,âmayâeatâthreeâmealsâperâday.âAsâwithâmostâethnicâgroups,âsoups,âstir-friesâorâsaladsâmayâbeâeatenâasâpartâofâtheâmainâmealâwithâcurryâandârice.âAlthoughâmeatâisâexpensiveâandâlessâavailableâinâBurma,âgoat,âfish,âporkâorâchickenâareâusedâinâtraditionalâdishes.â
Fruitâandâvegetables
Bambooâshoots,âmustardâleaves,âpumpkinâleaves,âcucumbers,âbeans,âgourds,âyams,âeggplants,âcassavaâleavesâandârosellaâleaves.âManyâvegetablesâareâalsoâfermented.âTheâKarenniâpeopleâmayâgrowâsomeâofâtheirâownâvegetablesâandâfruit.
Commonâfruitsâincludeâpapayas,âmangoes,âduriansâandâbananas.âJackâfruitâisâcookedâandâusedâinâsavouryâdishes.
Snacks Greenâteaâleafâsaladâ(Lephet thoke),âglutinousâriceâaroundâaâpalmâsugarâstick,âstreetâfoodâsuchâasâporkâskewers,âMohingaâ(riceânoodlesâinâaâfish-based,âcurry-flavouredâsoup)âandâfriedâtofu.
Beverages WaterâandâBurmeseâteaâ(green).âTeaâisâusuallyâdrunkâwithoutâmilkâandâunsweetened.âCoffeeâisâoftenâdrunkâwithâcondensedâmilkâbutânoâsugar.â
Mostâpeopleâareânotâfamiliarâwithâyoghurt;âhowever,âwhenâtheyâlivedâinâBurmaâmanyâpeopleâdrankâaâfermentedâmilkâdrink.
TheâKarenniâpeopleâinâBrisbaneâreportâmakingâandâdrinkingâtheirâownâriceâwineâinâBurma.
Celebrationâfoodsâandâreligiousâfoodâpractices
Festivalsâareâoftenâreligiousâand/orâcultural,âtakingâplaceâaroundâaâfullâmoon.âThingyanâ(WaterâFestival)âtakesâplaceâoverâthreeâtoâfourâdaysâinâAprilâandâcelebratesâtheâstartâofâtheânewâyear.âItâfeaturesâtheâthrowingâofâwaterâoverâpeopleâtoâsymboliseâtheâwashingâawayâofâsins.âTheâdayâofâBuddhaâisâcelebratedâinâMay,âcommemoratingâhisâbirth,âhisâenlightenmentâandâhisâachievementâofânirvana.âWagaung Maha Dokâ(âDrawâaâLotââFestival),âaâweek-longâreligiousâfestival,âtakesâplaceâinâAugust.âThadingyutâ(FestivalâofâLights)âtakesâplaceâinâOctoberâtoâcelebrateâtheâendâofâaâperiodâofâfastingâforâBuddhists.âFebruaryâisâHarvestâFestivalâtime,âwhenâharvestâfoodsâareâmadeâintoâHtamaneâ(aâglutinous,ârice-basedâsavouryâsnack).âKarenniâpeopleâcelebrateâtheâDeeKuâFestival,âwhichâoccursâinâSeptemberâorâOctoberâeachâyear,âwhereâdeekuâ(parcelsâofâstickyârice)âandâriceâwineâareâconsumed.
This information is to be used as a guide and is not intended to describe all members of the community. There will be cultural differences between people belonging to different regions, religions and social groups, as well as between individuals within any culture.
5Burmeseâfoodâandâculturalâprofile:âdieteticâconsultationâguide
Common traditional foods
Htamane,âmadeâfromâglutinousârice,âfriedâcoconutâshavings,âroastedâpeanuts,âtoastedâsesameâseeds,âgroundânutâoilâandâginger
Aâglutinous,ârice-basedâsavouryâsnack,âandâaâseasonalâfestiveâdelicacyâinâBurma.
Fungiâandâbeanâcurdâsoupâ(Karenâcuisine)
Anâexampleâofâaâtraditionalâsoup.
Chilliâpasteâ(mostâethnicâgroupsâuseâsomeâkindâofâchilliâpaste)
Mayâbeâusedâasâaâcondiment,âsprinkledâonâtopâofâmeals,âandâmayâcontainâdried,âsaltedâfish.
Laphetâ(Burmeseâteaâleafâsaladâorâpickledâteaâsalad),âmadeâfromâfermentedâgreenâteaâleavesâandâcrispâfriedâgarlic,âpeasâandâpeanuts,âtoastedâsesameâandâsometimesâdriedâshrimpâorâfish
Laphetâisâservedâinâmanyâceremonies.âItâisâalsoâeatenâasâaâsnackâorâafterâaâmeal,âwhenâitâisâcalledâLaphet thoke,âandâisâpreparedâwithâfreshâtomatoes,âgarlic,âgreenâchilliâandâshreddedâcabbage.âItâisâdressedâwithâfishâsauce,âsesameâorâpeanutâoil,âandâaâsqueezeâofâlime.âLaphetâisâavailableâinâindividual-serveâsizes,âwithoutâanyâfreshâvegetables,âfromâspecialtyâstoresâinâAustralia.â
Deekuâ(Karenni),âmadeâfromâstickyâriceâpackedâintoâgreenâleavesâandâboiled;âonceâcooked,âdippedâinâsugarâtoâeat
Theâdeekuâareâtiedâtogetherâinâthrees,âtoâsymboliseâunityâamongâKarenniâgroupsâwhoâjoinedâtogetherâtoâfightâinâcivilâwars.
Mohingaâ(Bamar) Anâopaque,âcurry-flavouredâfishâbrothâwithâriceâvermicelliâandâheartsâofâbananaâtreeâstems,âseasonedâwithâonions,âgarlic,âgingerâandâlemongrass.âItâisâoftenâservedâwithâhard-boiledâeggsâorâfriedâfishâcake.âMohingaâmayâbeâeatenâatâbreakfastâorâasâaâsnackâthroughoutâtheâday.
AâclearâKarenniâsoup Madeâfromâchickenâstock,âginger,âonionâandâmustardâgreens
*ââPhotosâofâHtamaneâandâMohingaâwithâpermissionâfromâhttp://www.shwemyanmar.info/index.phpâandâwww.ccfoodtravel.comâ,ârespectively.
This information is to be used as a guide and is not intended to describe all members of the community. There will be cultural differences between people belonging to different regions, religions and social groups, as well as between individuals within any culture.
6 Burmeseâfoodâandâculturalâprofile:âdieteticâconsultationâguide
StreetâfoodâinâBurma Meatâonâskewers,âfriedâtofu
Potatoâsaladâ(ShanâorâKarenni) Potatoesâareâservedâasâaâsideâratherâthanâaâstapleâpartâofâtheâmeal
FoodâhabitsâinâAustralia
Foodâpractices Commonâfoods:âRiceâandâcurry,âsoupsâwithâchilli,âstir-friesâandâsalads.
Mealâpatterns:âBurma-bornâpeopleâmayâeatâtoast,ânoodlesâorâfriedâriceâinâtheâmornings,âbutâmayânotâconsiderâthisâaââmealâ,âreportingâthatâtheyâdoânotâeatâbreakfast.âYoungâpeopleâmayâeatâaâpackagedâbreakfastâcereal.â
Eatingâpractices:âPeopleâmayâstillâboilâtapâwaterâinâAustraliaâorâpurchaseâbottledâwater.â
AdaptationsâtoâdietâinâAustralia
Substituteâfoods:âPotatoesâmayâbeâusedâinâplaceâofâyams.âManyâBurmeseâcommunitiesâinâBrisbaneâmayâuseâhalfâJasmineâandâhalfâBasmatiârice,âinsteadâofâallâJasmineârice.âMostâotherâvegetablesâareâavailableâinâBrisbane.
Changesâtoâdiet:âTheâChin,âKarenniâandâBamarâcommunitiesâinâBrisbaneâreportedâeatingâfewerâvegetablesâandâmoreâmeatâandâfruitâsinceâlivingâinâAustralia.âServeâsizesâareâalsoâgenerallyâreportedâtoâbeâbigger.
Otherâinfluences:âYoungâpeopleâinâparticularâmayâdrinkâsoftâdrinks,âandâmostâdrinkâfruitâdrinksâandâjuices.âThaiâstyle,âsweetenedâandâmilkyâtea/cordialsâservedâwithâjellyâpiecesâmayâalsoâbeâpopularâwithâtheâyoungerâgeneration.
Cookingâmethods Boiling,âfrying,âfermentation,âdryingâandâuseâofâmarinades.
Shopping/mealâpreparation
BothâmenâandâwomenâorâolderâchildrenâmayâbeâinvolvedâinâtheâpreparationâofâfoodâandâshoppingâinâbothâBurmaâandâAustralia.âMenâmayâcookâmoreâforâlargeâgatheringsâandâmayâbeâmoreâlikelyâtoâcookâmeat.
Foodâinâpregnancy Pregnantâwomenâmayâobserveâdietaryârestrictions,âincludingâtheâavoidanceâofâtraditionalâspicyâfoods.âKarenâwomenâmayâbelieveâthatâeveryâsight,âsound,âtouch,âtasteâorâsmell,âandâeveryâthoughtâandâactionâofâtheâmother,âhasâsomeâeffectâonâtheâfoetus.
Breastfeedingâandâfirstâfoods
Breastfeeding:âMostâbabiesâareâbreastfedâinâbothâBurmaâandâAustralia.âBreastfeedingâusuallyâcontinuesâforâaboutâtwoâyears.
Introductionâofâsolids:âItâmayâbeâseenâasâdesirableâtoâhaveâaâbigâbaby,âsoâsolidsâmayâbeâintroducedâearlyâinâanâattemptâtoââfattenâupââinfants.âAâcommonâfirstâfoodâisâpurĂŠedâwildârice.âYoungâchildrenâmayâbeâgivenâsoftâdrinksâorâfruitâdrinksâatâ1âtoâ2âyearsâofâage.â
Common traditional foods â continued
This information is to be used as a guide and is not intended to describe all members of the community. There will be cultural differences between people belonging to different regions, religions and social groups, as well as between individuals within any culture.
7Burmeseâfoodâandâculturalâprofile:âdieteticâconsultationâguide
During the consultation3.â Assessment
Keyâconsiderationsâ˘â âAnthropometry:âââItâisâacceptableâtoâmeasureâorâweighâpeople;âhowever,âitâisânotâpoliteâtoâtouchâthemâonâtheâhead.âItâisâacceptableâtoâ
measureâheightâwithâaâstadiometerâifâtheâhealthâprofessionalâexplainsâhow/whyâthisâisâdone.â
â˘â âMealâpatterns:âHowâmealsâareâdefinedâvariesâbetweenâcultures.âItâisâimportantâtoâaskâmoreâgenerallyâwhenâfoodâandâbeveragesâareâconsumedâthroughoutâtheâdayâratherâthanâaskâaboutâsetâmealâpatternsâ(breakfast,âlunchâandâdinner).â
Whenâtakingâaâdietâhistory,âbeâsureâtoâcheckâtheâfollowing:
Prompt Why?
â â âRegionâofâorigin,âi.e.âwhatâstateâofâBurmaâisâtheâclientâfrom,âandâisâitâcoastalâorâinland?
Differentâethnicitiesâcomeâfromâdifferentâstates,âandâdietaryâhabitsâmayâvaryâaccordingly.
â Amountâandâtypeâofâvegetablesâconsumed Traditionalâdietsâwereâhighâinâvegetablesâandâlowerâinâmeat.âVegetableâconsumptionâmayâhaveâreducedâsinceâmovingâtoâAustralia.âFermentedâvegetablesâmayâbeâroutinelyâconsumed.
â Amountâandâtypesâofâfruitsâconsumed FruitâisâmoreâwidelyâavailableâinâAustralia,âandâconsumptionâmayâhaveâincreased.
â Amountâandâtypeâofâoil/fatâusedâinâcooking Aâblendedâvegetableâoilâ(withâanâunhealthyâfattyâacidâprofile)âmayâbeâusedâforâcooking.
â Amount,âtypeâandâfrequencyâofâintakeâofârice Riceâisâeatenâatâmostâmeals.âChangesâinâtheâtypeâofâriceâeatenâhasâoccurredâforâsomeâKarenniâandâKarenâmigrants,âwithâtheâmountain/red/higher-proteinâricesâtraditionallyâeatenâbeingâsubstitutedâforâlargerâservesâofâjasmineâriceâinârefugeeâcampsâandâinâAustralia.
â Amountâofâsweetâfoodâconsumedâ(e.g.âbiscuits,âlollies,âcakesâandâcelebrationâfoods)
AccessâtoâtheseâfoodsâhasâincreasedâinâAustralia,âgenerally,âbutâtheyâareâespeciallyâpopularâwithâyoungerâpeople.
â Amountâofâsaltâaddedâtoâfoodsâandâuseâofâsaltyâcondiments Saltâorâcondimentsâsuchâasâfishâsauceâorâfishâpasteâareâaddedâregularlyâtoâdishesâorâusedâtoâmarinateâingredients.
â Takeaways/softâdrinkâconsumption AccessâtoâtheseâfoodsâhasâincreasedâinâAustralia.âYoungâpeopleâinâparticularâlikeâtoâdrinkâsoftâdrinksâandâmayâeatâtakeaways.
â Dietaryâchangesâdueâtoâculturalâorâreligiousâevents CheckâobservationâofâBuddhistâorâotherâreligiousâfestivalsâandâwhatâfoodsâareâconsumedâatâthisâtime.âTheâMuslimâRohingyanâobserveâRamadan,âlikeâotherâMuslimsâaroundâtheâworld.
This information is to be used as a guide and is not intended to describe all members of the community. There will be cultural differences between people belonging to different regions, religions and social groups, as well as between individuals within any culture.
8 Burmeseâfoodâandâculturalâprofile:âdieteticâconsultationâguide
4.â DiagnosisTheâfollowingâexamplesâmayâbeâusedâasâaâguideâforâcommonâPESS*âstatements.ââProblemsââareâtakenâfromâtheâNutritional Diagnosis Terminology eNCPT 2014,âwhichâisâavailableâfreeâinâtheâmembersââsectionâofâtheâDietitiansâAssociationâofâAustraliaâwebsite.
ExamplesâofâcommonâProblemsâ(P)âforâPESS*âstatements Commonâ(A)Etiologiesâ(E)âforâPESS*âstatements
Overweightâandâobesity
â˘â âExcessiveâenergyâintakeâ(NI-1.3)â˘â âExcessiveâoralâintakeâ(NI-2.2)â˘â âUnintendedâweightâgainâ(NC-3.4)â˘â âOverweight/obesityâ(NC-3.3)
â˘â âRelativeâabundanceâandâlowâcostâofâhighâsugarâfoodsâandâdrinksâandâmeatsâinâAustraliaâresultâinâhigherâintakes.â(NI-1.3)
â˘â âAcculturationâpressuresâtoâeatââAustralianââfoods,âespeciallyâforâchildrenâandâadolescents,âmayâleadâtoâhighâintakesâofâtakeaways,âconfectionaryâandâsoftâdrinks.â(NI-1.3,âNI-2.2.âNC-3.3)
â˘â âIncreasedâmealâsizesâonâarrivalâtoâAustraliaâbecauseâofâgreaterâavailabilityâofâaffordableâfoodsâ(NI-2.2)
â˘â âTraditionalâhighâintakeâofâriceâatâmealsâ(NI-5.8.2)â˘â âFastingâforâreligiousâreasons,âespeciallyâbyâ
Muslimsâ(NI-5.8.3)â˘â âChangesâtoâhigherâGIâricesâonâarrivalâinâAustraliaâ
dueâtoâtheirâlowerâcostâandâtasteâpreferenceâ(NI-5.8.3)
â˘â âBlendedâvegetableâoilâ(withâanâunhealthyâfattyâacidâprofile)âmayâbeâusedâforâcookingâbecauseâitâisâcheaperâthanâhealthierâchoices.â(NI-5.6.3)
â˘â âTasteâpreferenceâforâfoodsâcookedâwithâhighâsodiumâsauces/flavouringsâ(fishâsauceâandâfishâpaste)â(NI-5.10.2)
â˘â âLargeâamountsâofâsaltâaddedâduringâcookingâdueâtoâtasteâpreferenceâ(NI-5.10.2)
â˘â âShortâstayâinâAustraliaâandâunfamiliarityâwithâgovernmentâgeneratedâdietaryâguidelinesâandâhealthâpromotionâcampaignsâ(NB-1.1)
â˘â âLongâstaysâinârefugeeâcampsâwithâinadequateâfoodârationsâ(NI-5.2)
Typeâ2âdiabetes â˘â âExcessiveâcarbohydrateâintakeâ(NI-5.8.2)â˘â âIntakeâofâtypesâofâcarbohydrateâinconsistentâwithâneedsâ
(e.g.âhighâconsumptionâofâhighâGIârices)â(NI-5.8.3)
Cardiovascularâdisease
â˘â âExcessiveâmineralâintakeâ(sodium)â(NI-5.8.5)â˘â âIntakeâofâtypesâofâfatâinconsistentâwithâneedsâ(e.g.âhighâ
saturatedâfattyâacidâintake)â(NI-5.6.3)
General â˘â âFoodâandânutrition-relatedâknowledgeâdeficitâ(NB-1.1)â˘â âMalnutritionâonâarrivalâinâAustraliaâ(NI-5.2)
*âPESS:âProblem,â(A)Etiology,âSignsâandâSymptoms
ForâtheâSignsâandâSymptomsâ(SS)âforâPESSâstatements,âuseâstandardâclinicalâmeasurements.âMakeâsureâtheâSignsâandâSymptomsârelateâtoâtheâidentifiedâProblemsâandânotâtheirâ(A)Etiologies.â
This information is to be used as a guide and is not intended to describe all members of the community. There will be cultural differences between people belonging to different regions, religions and social groups, as well as between individuals within any culture.
9Burmeseâfoodâandâculturalâprofile:âdieteticâconsultationâguide
5.â InterventionNutritionâeducation
Motivatingâfactorsâforâaâhealthyâlifestyle
TheâZomi/Chinâpeopleâvalueâthriftiness,âsoâdietaryâadviceâthatâisâconsistentâwithâsavingâmoneyâmayâbeâmoreâlikelyâtoâbeâaccepted.â
TheâMuslimâRohingyanâareâunlikelyâtoâseeâlongevityâasâaâmotivatingâfactor;âasâwithâotherâMuslims,âlifespanâisâseenâasâpreordainedâbyâAllah.â
BecauseâaccessâtoâhealthâservicesâisâbetterâthanâpeopleâhaveâpreviouslyâexperiencedâinâBurmaâorâinârefugeeâcamps,âpeopleâmayâfeelâtheyâareâhealthierâinâAustralia.âAsâaâresult,âtheyâmayâbenefitâfromâsomeâeducationâonâtheââhealthyâmigrantâeffectâ,âi.e.âhowâmigrantsâareâhealthierâthanâtheâaverageâAustralianâwhenâarrivingâinâAustralia,âbutâmayâhaveâpoorerâlong-termâhealthâfromâchangesâtoâdietâandâreducedâphysicalâactivityâinâAustralia.
Preferredâeducationâmethods
Needâforâinterpreters:âAnâinterpreterâisâlikelyâtoâbeârequired.âYouâwillâneedâtoâorganiseâanâinterpreterâappropriateâtoâtheâclientâsâethnicity,âbutâbeâawareâthatâthisâmayâneedâtoâbeâaâtelephoneâinterpreter,âasâlocalâinterpretersâinâmanyâofâtheâlanguagesâmayânotâbeâavailable.
Typesâofâresources:âPictorialâandâvisualâresourcesâmayâbeâuseful.
Counsellingâstyle:âBeâawareâthatâsayingâânoââisâoftenâaâwayâofâbeingâmodest.â
Literacyâlevels TheâadultâliteracyârateâinâBurmaâisâ89.5%,âwithâmalesâhavingâslightlyâhigherâliteracyâlevelsâthanâfemales.9âLiteracyâratesâforâKarenniâpeopleâareâoftenâlow.1
Healthâbeliefs Theâhealthâofâaâpersonâisâcontrolledâbyâtheâfourâelementsâofâfire,âwater,âairâandâearth,âandâimbalancesâcauseâillnessâandâdisease.âCertainâfoodsâareâclassifiedâasââhotââorââcoldââandâcanâaffectâhealthâconditions.âHotâfoodsâareâgenerallyâthoseâthatâareâsalty,âsour,âorâhighâinâanimalâprotein.âColdâfoodsâareâgenerallyâbitterâorâsweet.â
TheâKarenniâpeopleâinâBrisbaneâreportâusingâgalangalâtoâsniffâtoâalleviateâcoldsâandâsickness,âandâapplyingâaâwildâtamarindâpoulticeâtoâhealâcuts.
Karenâpeopleâbelieveâillnessâcanâhaveâspiritualâasâwellâasâbiologicalâorâphysiologicalâcauses,âandâKarenâwhoâareâinâhospitalâwillâappreciateâaâvisitâfromâaârelevantâreligiousâleader.2
6.â MonitoringâandâevaluationMethodsâforâmonitoringââ˘â âCheckâifâtheâclientâhasâaccessâtoâtransportâ(especiallyâifâreferringâtoâanâoutpatientâclinic);âotherwiseâtelephoneâfollow-upâmayâbeâmoreâ
appropriate.
â˘â âConfirmâtheâclientâsâpreferenceâforâhavingâanâinterpreterâpresentâatâtheirânextâappointment.âForâshortâfollow-upâconsultations,âtelephoneâinterpretingâservicesâmayâbeâmoreâappropriate.â
â˘â âEncourageâwivesâtoâattendâtheirâhusbandsââfollow-upâappointments,âbecauseâtheâwomanâisâoftenâtheâprimaryâcookâinâtheâfamily,âevenâthoughâfoodâshoppingâandâpreparationâisâoftenâshared.
Additionalâresources
â˘â âQueenslandâHealthâWorking with Interpreters: Guidelinesâ(http://www.health.qld.gov.au/multicultural/interpreters/guidelines_int.pdf)
â˘â âToâfindâoutâmoreâaboutâmulticulturalâhealth,âQueenslandâHealthâsâMulticulturalâHealthâpageâhasâinformationâforâtheâpublicâandâforâhealthâworkers,âincludingâtheâMulticultural health framework.âGoâtoâhttp://www.health.qld.gov.au/multicultural/default.aspâ
â˘â âToâfindâoutâmoreâaboutâtheâMyanmar-bornâcommunityâgenerallyâinâAustralia,âvisitâhttps://www.dss.gov.au/our-responsibilities/settlement-and-multicultural-affairs/programs-policy/a-multicultural-australia/programs-and-publications/community-information-summaries/the-myanmar-born-communityâ
This information is to be used as a guide and is not intended to describe all members of the community. There will be cultural differences between people belonging to different regions, religions and social groups, as well as between individuals within any culture.
10 Burmeseâfoodâandâculturalâprofile:âdieteticâconsultationâguide
Additionalâresourcesâââcontinued
â˘â âHealthâcareâprovidersâinâQueenslandâcanâviewâaâcommunityâprofileâonâBurmeseâAustraliansârelevantâtoâthemâatâhttps://www.health.qld.gov.au/multicultural/health_workers/profiles-complete.pdfâ
â˘â âInformationâaboutâpracticesâinâpregnancy,âbirthâandâpost-natalâcareâofâMyanmar-bornâpeopleâcanâbeâfoundâatâhttp://www.health.qld.gov.au/multicultural/health_workers/cultdiver_guide.asp#pregnancy
References1.â Abbato,âS.âCommunity Profiles for Health Care Providers.âDivisionâofâtheâChiefâHealthâOfficer,âQueenslandâHealth.âBrisbaneâ2011.
2.â The Karen people: culture, faith and historyâ[Internet].âPublishedâbyâtheâKarenâBuddhistâDhammaâDhuttaâFoundationâŠâ2010,â2011â[citedâ22-07-15].âAvailableâfromâhttp://www.karen.org.au/docs/Karen_people_booklet.pdfâ
3.â DepartmentâofâPopulation,âMinistryâofâImmigrationâandâPopulation.âPopulation and Housing Census of Myanmar, 2014 Provisional Results Census Report: Volume 1â[Internet]âAugustâ2014â[citedâ22-07-15].âAvailableâfromâhttp://countryoffice.unfpa.org/myanmar/drive/Census_Provisional_Results_2014_ENG.pdfâ
4.â CentralâIntelligenceâAgency.âThe World Factbook: East and Southeast Asia: Burmaâ[Internet]â[placeâunknown]â2015â[citedâ2015,âJulyâ29].âAvailableâfromâhttps://www.cia.gov/library/publications/the-world-factbook/geos/bm.htmlâ
5.â LewisâM.âPaul,âGaryâF.âSimonsâandâCharlesâD.âFennigâ(eds).âEthnologue: Languages of the World, Eighteenth editionâ[Internet].âDallas,âTexas:âSILâInternationalâPublications;â2015â[citedâ22-07-15].âAvailableâfromâhttp://www.ethnologue.com/country/MMâ
6.â BBCâNews.âMyanmar profile â Timelineâ[Internet]â[placeâunknown]âŠâJuneâ2015âBBCâ[citedâ22-07-15].âAvailableâfromâhttp://www.bbc.com/news/world-asia-pacific-12992883
7.â DepartmentâofâImmigrationâandâCitizenship.âCommunity Information Summary: Myanmar-bornâ[Internet]âŠâCommonwealthâofâAustralia;âFebruaryâ2014â[citedâ22.07.15].âAvailableâfromâhttps://www.dss.gov.au/sites/default/files/documents/02_2014/myanmar.pdfâ
8.â BBCâNews.âMyanmar profile â Overviewâ[Internet]â[placeâunknown]âŠâJuneâ2015âBBCâ[citedâ22-07-15].âAvailableâfromâhttp://www.bbc.com/news/world-asia-pacific-12990563â
9.â DepartmentâofâPopulation,âMinistryâofâImmigrationâandâPopulation.âThe 2014 Myanmar Population and Housing Census. Highlights of the Main Results, Census report volume 2-Aâ[Internet]âMayâ2015â[citedâ22-07-15].âAvailableâfromâhttps://drive.google.com/file/d/0B067GBtstE5TWkJiaThxY08zZVU/view?pli=1â
10.â SBSâCensusâExplorerâ(usingâ2011âABSâCensusâdata)â[Internet]â[citedâJulyâ2015].âAvailableâfromâhttp://www.sbs.com.au/censusexplorer/â
11.â Chaves,âN.J.,âGibney,âK.B.,âLeder,âK.,âOâBrien,âD.P.,âMarshall,âC.âandâBiggs,âB.A.âScreeningâPracticesâforâInfectiousâDiseasesâamongâBurmeseâRefugeesâinâAustralia.âEmerging Infectious Diseases,â15(11),â1769â1772.âdoi:10.3201/eid1511.090777â[Internet]â2009â[citedâJulyâ2015].âAvailableâfromâhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2857247/â
AcknowledgementsWeâwouldâlikeâtoâacknowledgeâQUTâstudentsâforâtheirâhardâworkâinâtheâdevelopmentâofâthisâresource,âasâwellâasâBrisbaneâdietitiansâwhoâparticipatedâinâtheâFoodâandâCulturalâProfilesâReferenceâGroupâforâtheirâadviceâandâfeedback.
WeâwouldâalsoâlikeâtoâthankâmembersâofâtheâKaren,âBurmese,âKarenniâandâChinâcommunitiesâinâBrisbaneâforâgenerouslyâsharingâinformationâonâtheirâfoodâandâculturalâpractices.â
Forâmoreâinformationâcontact:AccessâandâCapacity-buildingâTeam
MetroâSouthâHealthâaccess&[email protected]â
ŠâStateâofâQueenslandâ(MetroâSouthâHealth)â2015
Pleaseânote:âTheâwebâlinksâinâthisâdocumentâwereâcurrentâasâatâMarchâ2015.âUseâofâsearchâenginesâisârecommendedâifâtheâpageâisânotâfound.