Asian remedy raises few alarms elsewhere People in cities with closer ties to Hmong culture say the issue no longer is a concern.
By: Jeremy Olson, Omaha World-Herald, May 3, 2002, Friday
The use of the Asian folk remedy cao gio probably wouldn't lead authorities to
remove children from their homes in American communities with deeper ties to
Hmong and Vietnamese cultures.
What happened in Omaha this week - police suspecting child abuse and removing
10 children from two families who performed cao gio on them - appears the
result of a lack of cultural awareness, said Hoa Tran, a bilingual liaison for
the Lincoln Public Schools.
Cao gio, commonly called coining, involves the rubbing of warm oils or gels
across a person's skin with a coin, spoon or other flat object. It leaves
bright red marks or bruises, but many Asian families believe the marks
represent bad blood rising out of the body and allow improved circulation and
"Over here, it is no problem," said Tran, who also interprets for Lincoln police.
Employees at an Omaha elementary school notified police when they discovered
the marks on some of the children. Authorities in Omaha then removed the
children from their families Tuesday after some of them indicated that the
bruises were painful.
Misinterpretations of coining have occurred in many cities and created
distrust of American health care, according to a March 2000 report in the
Journal of the American Academy of Nurse Practitioners.
Mark Pfeifer of the Hmong Cultural Center in St. Paul, Minn., remembers child
abuse complaints related to coining taking place in the 1980s, but not since
then. The Twin Cities has a large Hmong population.
"I haven't heard of that issue here for a long time," he said.
Lincoln's increased knowledge of coining stems from the large Vietnamese
population that started moving to the city more than a decade ago, said Lincoln
Police Chief Tom Casady.
"We've had a longer period of time to learn of the practice of coining and to
incorporate that into our child abuse training."
New Lincoln police officers are trained to recognize coining and to
differentiate it from child abuse. Tran, whose family uses coining, educates
Lincoln teachers and students at the University of Nebraska Medical Center in
Omaha about it.
Lincoln police still receive tips about children who have bruises that are the
result of coining and must investigate them. Police in most cities have a
better-safe-than-sorry approach to investigating child abuse complaints. But
police officials there could not recall making arrests or removing children
from their homes in any recent cases.
Lincoln police and other officials were careful not to judge the Omaha police
decision, noting that child abuse can occur within families that practice
coining, and that such remedies can be harmful if used inappropriately.
Nationally, fear of losing their children prevents many Asian women from doing
coining, even if they believe in it, said Ruth Davis, head of the nursing
school at Millersville University in Pennsylvania and author of the nurse
Health care providers should know better than to mistake it for abuse, and so
should anyone who works with Asian children, she said.
"If you take a coin and rub your skin, you're going to get a bruise.
Physiologically, that is what happens, but it's not used as a form of
Vanderbilt University Medical Center includes an image of the long red bruises
created by coining on its Web site so its doctors can correctly distinguish the
practice from child abuse.
"The back or chest is vigorously rubbed with a coin and these lesions are
produced," the Web site statement says.
"The lesions themselves are of no significance. They should not be mistaken for
child abuse in pediatric patients."
The University of Washington offers a pictorial description of coining at
Doctors who used to discourage coining found that that only created resentment
among Asian patients, according to a 1980 article in the Journal of the
American Medical Association. The authors found that coining is used to treat
colds, flu and headaches and applied the most often to the back, neck, chest or
A supervisor of child-protective services in Minnesota said investigations
should take place if there is any suspicion of abuse. But Dorothy Renstrom said
that removing children isn't always necessary and that authorities should offer
to teach families about alternatives to coining.
She first learned of coining when she worked in Lincoln.
Many doctors believe coining is legitimate and have used it. Dr. Laeth Nasir
of the NU Medical Center said he uses a variation on patients suffering from
Anh Tran, a health outreach worker in Lincoln, said her relatives use coining,
but she doesn't like it. She has been in contact with one of the Omaha families
- which previously lived in Lincoln - and said she believes what is happening
to them is wrong.
"It would never go this far here," she said.
"In Lincoln, it's well-known. It's nothing new."
Tran, the Lincoln schools liaison and police translator, believes in coining
as a low-cost remedy, but it is not the only one for his family.
"We also take American medicine," he said,
"like Tylenol or something."
GRAPHIC: Color Mugs/4 Dinah Lor Aaron Lor Kanoo Lor David Chang Color Photo/1
VANDERBILT UNIVERSITY/1, This patient has undergone the Asian folk remedy of
coining, or cao gio. The Vanderbilt University Medical Center in Tennessee uses
the photo to help its doctors distinguish these long, red bruises from ones
inflicted during child abuse.; VANDERBILT UNIVERSITY/1