Mongolian History, Culture, and Application
Mongolia is a landlocked, democratic Central Asia country with Russia being directly north and China to the south. Approximately 3,068,243 people reside in Mongolia. In the Mongolian countryside, many inhabitants still practice a nomadic lifestyle (May, 2009). However, following urbanization, many citizens live in towns and cities such as the capital, Ulaanbaatar. The majority ethnic group that makes up Mongolia is called the Khalkh. The majority of the population of Mongolia speaks Mongolian in reference to the Khalkha dialect. Modern written Mongolian is based in Cyrillic. Buddhism and shamanism are the prevailing religions in Mongolia. Following the collapse of communism in 1990 and the establishment of the democratic system in Mongolia, the state revitalized Buddhist influences and other ethnic Mongol ideals, such as traditional medicine. Traditional and modern Western medicine are integrated in Mongolia and are protected by the Mongolian parliament. In order to be culturally sensitive when working with this population, it is important to keep in mind their language, religion, and other customs in order to cultivate trust between the audiologist and the patient.
Mongolia itself a landlocked Central Asian country enclosed by Russia to the north and China to the south. Mongolia itself is a part of what is known as the Mongolian Plateau that consists of Mongolia and Inner Mongolia (Park, Fan, John, & Chen, 2017). Inner Mongolia is an self-governing portion of the People’s Republic of China while Mongolia itself is a sovereign country (Park et al., 2017). The capital city of Mongolia is Ulaanbaatar (Park et al., 2017). Mongolia extends approximately 1.56 million square kilometers (Embassy of Mongolia, 2018).
The country of Mongolia consists of several different climates. Ulaanbaatar rests in a temperate grasslands/savannas/shrublands climate zone (Park et al., 2017). Grasslands cover approximately 75% of Mongolia (Fernandez-gimenez, Fassnacht, & Batkhishig, 2015). Just north of it lies a boreal forests climate zone. Mountain and steppe terrains are two additional terrain types found in Mongolia (Embassy of Mongolia, 2018). Directly south of Ulaanbaatar is primarily made up of deserts (Park et al., 2017). One such famous desert located in southern Mongolia is the Gobi desert.
The Gobi desert occupies an area of approximately 501,930 square miles (Dennell, 2012). The mean temperature range in Celsius -18 20 (Dennell, 2012). The Gobi desert is among the coldest deserts in Central Asia in which it is below freezing temperatures for a minimum of two months every year (Dennell, 2012). The Gobi desert is both classified as arid and hyper-arid, which is determined in accordance with the average amount of rainfall (Dennell, 2012). The precipitation rate in the hyper-arid classification is approximately less than 25 mm whereas in the arid classification the precipitation rate is approximately less than 100 mm (Dennell, 2012).
The population of Mongolia is approximately 3,068,243 with about 2 people per square kilometer (Central Intelligence Agency, 2018). Mongolia is ranked 135 compared to the world whereas the United States (US) is ranked at number 3 in the world (Central Intelligence Agency, 2018). The majority of the Mongolian population falls between 25 and 54 years of age while those who are between 0 to 14 years of age make up about 27% of the population (Central Intelligence Agency, 2018). Those between the ages of 15-24 years of age make up about 16% of the population. Seniors aged 55-64 years of age make up about 7% while those 65 years of age and older make up about 4.3% (Central Intelligence Agency, 2018). The median age among both sexes in Mongolia is about 28 years old with the female sex averaging 29 years old and the male sex averaging about 28 years old (Central Intelligence Agency, 2018). Mongolia is ranked 131 compared to the world whereas the US is ranked at 60 compared to the world (Central Intelligence Agency, 2018).
The birth rate is approximately 19 births per every 1,000 (Central Intelligence Agency, 2018). Mongolia is ranked 88 compared to the world whereas the US is ranked 158 compared to the world (Central Intelligence Agency, 2018). The life expectancy of Mongolians is about 70 years old with the female sex living longer above the average at about 74 years old (Central Intelligence Agency, 2018). Mongolia is ranked 160 compared to the rest of the world (Central Intelligence Agency, 2018). The percentage of Mongolians who are literate is 98.4 (Central Intelligence Agency, 2018).
Unemployment rates for ages 15 through 24 are approximately 21% of that population (Central Intelligence Agency, 2018). The unemployment rate for the Mongolian population is about 7% (Central Intelligence Agency, 2018). About 30% of the Mongolian population falls below the poverty line (Central Intelligence Agency, 2018). The lowest 10% in regards to the household income of the Mongolian population makes up 14% whereas the highest 10% falls at 6% of the Mongolian population (Central Intelligence Agency, 2018).
The majority of diversity in Mongolia is made up of the Khalkh ethnic group at about 82%; the minority ethnic groups in Mongolia are Kazak at 3.8%, Dorvod at 2.7%, Bayad at 2.1%, Buryat-Bouriates at 1.7%, Zakhchin at 1.2%, Dariganga 1%, Uriankhai at 1%, and other at 4.6% (Central Intelligence Agency, 2018). The majority of the population who reside in Mongolia speak Mongolian at 90% with the Khalkha dialect being the most common (Central Intelligence Agency, 2018).
The Mongolian language has changed over the course of multiple centuries. Mongolian itself is a part of a language family called Mongolic (Janhunen, 2012). Under the rule of Chinggis Khan in the 12th century, Mongolic was created due to medieval Mongolian expansion and unification across Central Asia (Janhunen, 2012). Back in this century, Middle Mongolian was primarily utilized in the military and in the government. Middle Mongolian consisted of several different written scripts in which modern Mongolian was actually derived from (Janhunen, 2012).
The current surviving derivations Middle Mongolian are distributed amongst four linguistically discrete subdivisions: Dagur, Common Mongolic, Shirongolic, and Moghol (Janhunen, 2012). Common Mongolic is the only subdivision of modern Mongolian that is spoken in geographic Mongolia; Dagur, Shirongolic, and Moghol are utilized in Manchuria, Tibet, and Afghanistan, respectfully (Janhunen, 2012). Common Mongolic itself is comprised of six different dialects: Khalkha, Khorchin, Ordos, Khamnigan, Buryat, and Oriat (Janhunen, 2012). An individual who speaks one dialect of Common Mongolic can understand another speaking a different dialect as there is a degree of joint intelligibility (Janhunen, 2012). Like the spoken dialects of Common Mongolic, its written form is just as diverse and expansive.
Cyrillic Khalkha, also known as the “New Script”, became the official written language of Mongolia in the 1940s (Janhunen, 2012). The dialect itself, Khalkha, became the official language of Mongolia after Mongolia gained its independence. The “Old Script”, Written Mongol, is currently still used by those who use the dialects Khamnigan and Buryat who live in Inner Mongolia (Janhunen, 2012). The “New Script” is utilized in Mongolia and is known among those who are educated living in Inner Mongolia (Janhunen, 2012).
Shamanism is one of the oldest religious practices that are still in existence today in modern Mongolia albeit not widespread (May, 2009). Shamans themselves are an intermediary individual who can communicate between the spirit world and the human world (May, 2009). They typically utilize bones or allow the spirit itself to enter their body (May, 2009). Shamans who speak to these spirits can also foresee the future (May, 2009).
Shamanism did particularly decline in Mongolia after the introduction of Buddhism in 1575 (May, 2009). However, Buddhism did adopt some of the principles of shamanism such as utilizing blessed silk that when it blows in the wind the prayer is brought to heaven (May, 2009). Shamanism continued to exist with the Buryats and the eastern provinces of Mongolia after this time (May, 2009). The revival of shamanism began in 1991 once democracy was established in Mongolia (May, 2009).
As Buddhism dispersed across the country, urbanism in Mongolia was a direct consequence (May, 2009). Thousands of monasteries became the center of the community as they served as a shelter stocked with medical supplies and food in times of war and strife (May, 2009). Upon winning its independence in 1912, Mongolia established a theocracy utilizing the main principles of Buddhism during this time until it was overrun by communism in 1939 (May, 2009). Buddhism was revitalized following the collapse of communism in 1990 and new monasteries were established throughout the country (May, 2009). Buddhism in Mongolia transcended traditional religious practices and entered its way into the daily lives of Mongolians, influencing customs that are still practiced in modern Mongolia.
Beginning in the seventeenth century, Buddhism has heavily influenced Mongolian religious, national, and cultural identity (Kollmar-Paulenz, 2003). Most Mongolian names during this time had a Buddhist influence (May, 2009). Even the days of the week are commonly referred to by its Tibetan Buddhist name (May, 2009). During the communist occupation of Mongolia, Tibetan names were less commonly in use; however, upon the fall of communism, Tibetan naming has become more commonplace (May, 2009).
In modern Mongolia, Buddhism still has a significant influence on cultural identity. For example, Buddhism influenced Mongolian funerary traditions that are still utilized in modern-day Mongolia (May, 2009). One such tradition is where Lamas direct the funeral proceedings and bodies may be buried or left exposed in the countryside of Mongolia; this became legalized in the country following the fall of communism in 1990 (May, 2009).
Upon the revival of Buddhism after the fall of communism, the government of Mongolia became financially involved in restoring Buddhist monuments thereby solidifying Buddhism’s significant influence on the national identity of Mongolia (Kollmar-Paulenz, 2003). The country’s flag, seal, and state emblem, for example, are all influenced by Buddhism and are described at length in the Mongolian Constitution (Kollmar-Paulenz, 2003). The state emblem, in particular, incorporates Mongolian beliefs about the energy of their rule and the soul represented by a white lotus; the white lotus is an extremely significant religious symbol in Buddhism (Kollmar-Paulenz, 2003). Moreover, the symbols of Mongolia’s sovereignty are represented by Buddhist folklore symbols: “…the keyimori (wind-horse), the cindamani (precious jewel), and the ghurban cagh (past, present, and future)” (Kollmar-Paulenz, 2003). Furthermore, Western influences provided loans and grants for their new market economy and a state to model after.
Mongolia’s modern history is marked by communism, the fall of communism, and democracy. Mongolia was under communist rule between 1921 and 1990 (Rossabi, 2005). The state’s only lawful political party during the communist regime was dubbed the Mongolian People’s Revolutionary Party (Rossabi, 2005). Ultimately, Mongolia was officially renamed to Mongolian People’s Republic (MPR) in 1924 (Rossabi, 2005). The communist regime was established upon independence from China in July 1921 upon the fall of the Qing dynasty (Rossabi, 2005).
During the communist regime, MPR followed the policies set forth by the Soviet Union such as the goals of industrialization, urbanization, and collectivization (Rossabi, 2005). Following typical Communist practices, the government of MPR collectivized the herds by 1959 thus turning the herders into workers of the collective (Rossabi, 2005). Industrialization occurred after collectivization. Two new cities were established, Darkhan and Erdenet (Rossabi, 2005). In Darkhan, flour and leather mills, as well as construction businesses, were established (Rossabi, 2005). By 1978, more than half of the population in MPR were living in urbanized towns and cities (Rossabi, 2005). Between 1950 and 1989, the population in MPR more than tripled (Rossabi, 2005). As the population increased, the markets were unable to keep up food production for the growing population (Rossabi, 2005).
The fall of the communist regime in Mongolia began with the children of the Mongolian elitists who believed in non-violence (Rossabi, 2005). From here, the reformers mostly originated from professional and intellectual classes (Rossabi, 2005). Because the movement started from the top of the social hierarchy pyramid, the trickle-down effect occurred thus inspiring those in the bottom classes of the social hierarchy pyramid (Rossabi, 2005). The reformers primarily emphasized reverting back to ethnic Mongol traditions like practicing Buddhism; most ethnic Mongol traditions were seen very negatively during the communist regime (Rossabi, 2005). The one-party rule in MPR had been abolished, and new democratic parties arose (Rossabi, 2005).
In 1990, after the fall of the communist regime, the US Secretary of State James Baker visited modern day democratic Mongolia (Rossabi, 2005). The Secretary had intentions to help Mongolia to establish a market economy following Mongolia’s first multiparty elections by offering monetary assistance (Rossabi, 2005). Financial organizations like the World Bank and the International Monetary fund approved the new democratic sovereign state, Mongolia, for loans and grants (Rossabi, 2005). Mongolia received even more monetary support and support for their newly established democracy and the start of their new market economy from their Western supporters (Rossabi, 2005).
Following the establishment of a market economy in Mongolia, the need to establish positive relations with various world powers arose (Rossabi, 2005). Mongolia restored good relations with Russia (Rossabi, 2005). Mongolia continued to strengthen its relationship with the US by cooperating with American scientists and archaeologists digging for relics in Mongolia and increasing collaboration with military efforts with the West (Rossabi, 2005). Western European nations contributed to the economic gains of Mongolia and to their culture (Rossabi, 2005). Good relations with previous communist allies have not improved since the fall of communism in Mongolia (Rossabi, 2005). Because of Mongolia’s geographic location, the need arose for the state to try and develop some sort of relations with either Russia or China or both (Rossabi, 2005).
In the late 1990s, good relations between China and Mongolia were re-established (Rossabi, 2005). The two states agreed, upon resolving prior political problems, that they decided to collaborate on issues of public health, education, culture and technological advancements (Rossabi, 2005). China and Mongolia also had agreed to cooperate on resolving border issues in regards to illegal entry into the state and war on drugs (Rossabi, 2005). Closer economic relations between China and Mongolia also resulted from their re-established relations (Rossabi, 2005).
Mongolian Approach to Medicine
Traditional Mongolian medicine has been incorporated into modern healthcare (Gerke, 2004). Since the rise of democracy in Mongolia, the addition of traditional healthcare has helped shape the identity of Mongolians (Gerke, 2004). Western medicine was introduced by the USSR in 1921 (Gerke, 2004). In today’s Mongolia, Western and traditional health care are both supported and protected by the government (Gerke, 2004).
For physicians wanting to practice both traditional and Western medicine, they must have a Western medicine, M.D. degree, as well as a degree in traditional Mongolian medicine (Gerke, 2004). The Mongolian physician must undergo 1800 – 2000 hours of coursework in order to be licensed in traditional medicine (Gerke, 2004). The Traditional Mongolian Centre of Liver Diseases in Ulaanbaatar is one such center that utilizes both traditional and Western medicine (Gerke, 2004). Western medicine, at this center, is set aside for emergencies only; however, traditional therapies and methods are used primarily (Gerke, 2004).
The main diagnosis method in traditional Mongolian medicine is pulse-reading (Gerke, 2004). The pulse-reading is taken with both rests in order to detect anything out of the ordinary (Gerke, 2004). Bloodletting, acupuncture, cupping, and Vipassana meditation are a few other examples of traditional medicine used in Mongolia (Gerke, 2004). Although Vipassana meditation is of Indian Ayurvedic origin, the physician’s at the Centre believe in the combination of traditional and modern medicine of any origin that can help their patients (Gerke, 2004). However, in the countryside of Mongolia, physicians typically follow traditional Mongolian medicine due to the wide availability of raw materials and medicinal plants (Gerke, 2004).
For the integration of traditional medicine into modern, Western medicine to be successful, the Mongolian government does supply quality control in regards to medications and raw materials for the medications (Gerke, 2004). The insurance companies even support traditional medicine as procedures and therapies are covered (Gerke, 2004). Traditional medicine can be received anyone in Mongolia who wants to receive it (Gerke, 2004). Traditional medicine in Western culture is often reserved for the elite classes, however in Mongolia that is not the case (Gerke, 2004).
Application of Mongolian Cultural Sensitivity in Audiology Practice
The first step in being sensitive to Mongolians is to provide an interpreter that specializes in their dialect. The audiologist should look into their patient’s birthplace ethnicity information before requesting services from an interpreter.
In Mongolian culture, it is considered a huge offense and breach of trust if one touches the head or hair of another individual without their consent to do so (May, 2009). Therefore, audiologists should always remember when working with this culture to ask the patient for their permission to touch their head before putting headphones or inserts on their ears.
If a Mongolian patient is pregnant, it is considered offensive if you speak loudly to her (May, 2009). Therefore, audiologists should take care to lower their voices from the “audiologist voice” to normal conversation level in front of this patient population so as not to be offensive.
Knowing the religious background of a Mongolian patient might be particularly helpful especially if a child the audiologist is sick. If the Mongolian patient believes in shamanism, they believe that sickness is brought on in the individual by malicious spirits (May, 2009). These patients may prefer to call the child Nerguai or “no-name” so as to confuse these malicious spirits into leaving the child thus relieving them of the sickness (May, 2009). An audiologist should respect these patient’s culture if treating a sick child. The parents may consider a hearing loss or otitis media as a sickness and calling the child Nerguai when working with them may instill a sense of trust with these patients.
Central Intelligence Agency. (2018). East & Southeast Asia: Mongolia. Retrieved from https://www.cia.gov/library/publications/the-world-factbook/geos/mg.html
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Embassy of Mongolia. (2018). Geography and Climate. Retrieved November 11, 2018, from http://mongolianembassy.us/about-mongolia/geography-and-climate/#.W-j9V3pKg1g
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