Hmong doctor opens pioneering practice

Fenglaly Lee is Fresno’s first female Hmong OB/GYN.
By Vanessa Colón / The Fresno Bee

Dr. Fenglaly Lee grew up as a refugee in Fresno living on welfare and harvesting Asian vegetables on the weekends.

Now, she is delivering babies as the first female Hmong OB/GYN doctor in the central San Joaquin Valley and possibly the state.

Her arrival provides the Valley’s large population of Hmong women with a physician who understands Hmong customs and can explain why it sometimes is necessary to set customs aside for the patient’s health.

Lee opened a private practice in downtown Fresno in August and delivers babies at Community Regional Medical Center. Lee, 33, felt compelled to pursue a college degree after watching how hard her parents worked harvesting green beans, sugar peas and cherry tomatoes. The death of her father after a stroke in 1998 propelled her to study medicine.

Lee said it’s a big leap from refugee to physician but it’s an important achievement.

The Valley has at least seven Hmong physicians including Dr. Mouatou Mouanoutoua, a cardiologist in Fresno through the University of California at San Francisco; Dr. Long Thao, a family practitioner in Merced; and Dr. Tou Vang, a pediatrician in Fresno.

“It is overwhelming sometimes, but overall it’s exciting to have such a big stride. It was not a shock. I know in general there is a lack of Hmong physicians in Hmong society,” Lee said.

About 33,000 residents of Hmong descent live in Fresno County. Merced County has more than 6,000 residents.

Lee arrived in Fresno from Laos when she was 6 or 7 years old.

She grew up with three sisters, five brothers, and parents who earned about $10,000 a year in the 1980s. Her family went off welfare in 1987 when her father opened a shipping and packaging business in the Valley.

Lee wanted more from life than farmwork and an early marriage. She persuaded the high school to let her skip the eighth grade and enter ninth grade so she could graduate quickly.

“I was afraid I was going to get married too soon, so I wanted to hurry up and go to college,” she said.

Lee graduated from McLane High School in 1992. At 19, she married Long Lao. Lee earned a bachelor’s degree in physiology from the University of California at Davis in 1997, then graduated from UC Davis’ medical school in 2003. Lee did her residency at UCSF in Fresno.

“She’s small but very assertive. She’s always been a tremendous leader,” said Dr. Jeffrey Thomas, associate program director at UCSF-Fresno’s OB/GYN residency and training program.

Thomas describes her as motivated and much in demand when she opened her private practice.

“She had people waiting for her to graduate. There was a need,” he said.

Thomas said she has been an asset to medical students and physicians in the Valley. He learned from her that Hmong women follow a diet of boiled chicken and rice after giving birth. Thomas said it was helpful to understand Hmong customs such as patients who consult their parents on a decision for surgery.

Ma Yang, who gave birth to a baby boy Nov. 12, said she was relieved to have a Hmong doctor who understood her. Lee speaks Hmong.

“It makes me feel more comfortable. … I know I can open up and tell her my problems,” Yang said.

She said her baby’s head faced upward instead of downward. Hmong custom is for Hmong midwives to reposition the baby so its head is facing down for delivery.

Yang said Lee told her she shouldn’t have allowed the midwives to do that, even if it’s a Hmong custom, because that kind of forced movement can injure the baby. Luckily, the baby was fine and Yang and her parents agreed that Yang should have a Caesarean section. Yang’s parents initially didn’t want her to have a Caesarean, but changed their minds after listening to Lee.

“She made a good decision. She said I needed an emergency C-section,” Yang said of Lee.

Lee said she respects Hmong customs such as getting advice from the clan or parents. But she advises her patients about the risk of death in delaying a Caesarean section.

“I don’t think they understand the level of fetal deaths. I don’t discourage the practices, [but] if it’s harmful I’d discourage it.”

Lee hopes to motivate more Hmong women, especially the older generation, to have pelvic exams and Pap smears.

“They’ve never been encouraged to get health screenings or medical screening until the conditions are terminal,” Lee said.

Lee has a busy life. She has an 8-year-old girl and two boys ages 2 and 5. Lee also mentors a female undergraduate at California State University, Fresno, in addition to holding a faculty position at UCSF-Fresno.

Thomas said he admires Lee because she came back to Fresno and is helping other medical students as well as her community.

“She could have gone north, but she stayed in downtown to give back to the community that supported her. … She’s the real deal,” Thomas said.
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