First-Wave Immigrants

The arrival of East Indians from the Indian subcontinent during the first two decades of the twentieth century caused considerable uproar along the Pacific Coast of Canada and the United States ( ). Although East Indians immigrated to these countries in very small numbers, their immigration coincided with increasing American hostility toward the Japanese. Before the nineteenth century, very few Hindu Indians migrated oversees from the Indian subcontinent because most Hindu Indians believed that crossing the “black waters” was dangerous to the Hindu soul. By 1900, the U.S. Bureau of the Census reported that 2050 East Indian residents had immigrated to the United States. Many of the immigrants in this group were non-Indians who were born in India, some were Indian students, and some were Indian businessmen ( ).

In 1901, East Indian students began arriving in the United States to enroll in various colleges and universities throughout the East Coast area. Many of these students enrolled in such prestigious institutions as Cornell University. It was not until 1904 or 1905 that East Indian students began to immigrate to the western portion of the United States to enroll in such universities as the University of California and the California Polytechnic Institute. Students were not the only immigrants who were included in this first major wave of Hindu Indians. During this period, U.S. ports of entry began to register major increases in East Indian immigrants; from 1904 to 1906, 674 East Indians immigrated, compared with only 9 in 1900. The majority of the East Indian immigrants were unskilled agriculturalists and small entrepreneurs from the arid lands of the Punjab, the United provinces, Bengal, and Gujarat ( ).

From the onset of the first wave of East Indian immigrants, these people were classified as Hindus (or Hindoos) regardless of their home, culture, or religion. The mandated that any native of India was to be considered a Hindu for immigration purposes ( ; ). In 1917 Congress passed, over President Wilson’s veto, an immigration restriction act for East Indians. This new law required a literacy test and also encompassed a barred zone for immigration. All Asians who resided in India, Southeast Asia, the Indonesian islands, New Guinea, or regions of Arabia, Afghanistan, or Siberia were excluded by the new immigration law ( ).

Second-Wave Immigrants

In 1909, Canada closed its doors to East Indian immigrants; however, immigration of East Indians to the United States continued for another 5 years. The Immigration Exclusion Act of 1917, which excluded most persons of East Indian descent, including Hindu Indians, severely curtailed the number of Hindus in the United States. The number of East Indian immigrants residing in the United States began to decline sharply in 1910. In that year, the U.S. Commission reported that there were some 5000 East Indians residing in the United States, but in 1930 this number was disputed by the U.S. Bureau of the Census, which reported that there were only 2544 East Indians residing in the United States, most in California. In 1946, President Harry Truman signed into law a bill that allowed East Indian immigration on a quota basis and allowed naturalization of East Indians. This law is credited with beginning the second wave of immigration of East Indian Hindus to the United States.

These new immigrants, who arrived after World War II and before 1965, were mostly professional Hindu people and their families. These immigrants came mostly from large cities of Mumbai (formerly called Bombay) and Calcutta ( ).

Third-Wave Immigrants

In 1965, an immigration law marking the beginning of a third wave of immigrants to the United States was enacted. The Immigration Act raised quotas for Asians to the same level as Europeans, facilitating entry to the United States ( ). Although the first-wave immigrants were primarily agriculturists with some students and the second-wave immigrants were primarily university-educated professionals and their families, the third-wave immigrants were entirely different ( ). These new generations of immigrants were very young, with 3 out of 5 under 30 years of age and 1 out of 7 less than 10 years of age. In 1974 approximately 12,777 East Indians resided in the United States; by 2009 this number significantly increased to more than 2.5 million people ( ).

Initially these immigrants were predominantly male, coming to the United States for graduate education in the science and business fields. Eventually, in the 1980s, women who wanted an education started arriving. Among Asian Indian males, 91.0% have at least a high school education compared with 93.4% of Asian Indian females; 74.6% of males and 64.8% of females have at least a bachelor’s degree ( ). In addition, these new immigrants may not be coming directly from India. Many have emigrated from other countries in Asia and Europe before coming to the United States ( ).

It is essential to distinguish who are the East Indian Americans. Indian Americans are of Asian descent and either were born in or native to India or have ancestors who were born in or native to India ( ). To make a clear distinction and difference between Indians of Asian origin and Indians who are indigenous peoples of the Americas, the U.S. Census Bureau popularized the term “Asian Indians” to avoid confusion with the term “American Indian” ( ). In 2010, there were 2,578,978 people of East Indian descent or from the Indian diaspora (Asian Indians) residing in the United States ( ). The median age of Asian Indians in 2010 was 32.0, compared with 36.7 for the rest of the general U.S. population. The number of married-couple East Indian Hindu Americans (Asian Indians) represented 71.9% of that population, compared with 49.3% of the general U.S. population. In 2009, the median per capita income of Asian Indian males was $71,605, compared with $45,320 for the rest of the general U.S. population. Similarly, for Asian Indian women, the median per capita income was $51,316, compared with $35,299 for the rest of their female counterparts. The median family income was also higher for Asian Indians. In 2009, the median family income for Asian Indians was $98,508, compared with $62,367 for the general U.S. population ( ).

Origins of Hindustani Dialect

Language is a means of communication, and it disseminates new ideas. It is the storehouse of tradition and literature that provides a people with a sense of pride, self-confidence, and emotional unity. The national elite groups of a culture emphasize the value of a common language as a unifying force and the necessity for the development of language and literature. The study of linguistic heritage not only is an end in itself but also serves to establish the conditions for nationhood ( ).

Hindustani (the name given by Europeans to an Indo-Aryan dialect), as a result of political causes, has become the great lingua franca of modern India. The name is not used by natives of India, except as an imitation of the English nomenclature. Hindustani is by origin a Hindi dialect of western India. Hindustani has been called a mongrel pidgin form of speech composed of contributions from the various languages spoken in a Delhi bazaar. This theory has not been disproved because of the discovery that the language is the actual living dialect of western India, which has existed for centuries in its present form ( ).

Hindustani is the natural language of the people of Delhi. Because the origin of Hindustani began with the people in the Delhi bazaar, it became known as “bazaar language.” From the inception of Hindustani, this language became the lingua franca of the mongrel camp and was transported everywhere in India by the lieutenants of the empire. Several recognized forms of the dialect exists, such as Dakhini, Urdu, Rekhta, and Hindi. Dakhini, or “southern,” is the form in current use in southern India and the first to be used in the literature. It contains many archaic expressions now extinct in the standard dialect. Urdu, “the language of the camp,” is the name usually used for the Hindustani by natives and is now the standard form of speech used by Muslims. All the early Hindustani literature was written as poetry, and this literary form of speech was named Rekhta, or “scattered,” from the way in which words borrowed from Persia were scattered through it. Hindustani is the dialect used in poetry, with Urdu being the dialect of prose and conversation ( ).

There are approximately 18 languages spoken in India, with Hindi being the most prevalent (40.2%). Bengali is spoken by 8.3% of the population, Telugu by 7.9%, Marathi by 7.5%, Tamil by 6.32%, Urdu by 5.2%, Gujarati by 4.8%, Kannada by 3.9%, Malayalam by 3.6%, Oriya by 3.4%, Punjabi by 2.8%, Assamese by 1.6%, Sindhi by 0.3%, Nepali by 0.3%, Konkani by 0.2%, Manipuri by 0.2%, Kasmiri by 0.01%, and Sanskrit by 0.01%. All but Nepali, Konkani, and Manipuri are considered official languages ( ; ).

Hindi is the official language of India. English is considered to be an associate official language, with some states declaring it as their official language. The use of English in India is in a fairly fluid state because of the political ideology of each state. The languages taught in the education system are variable, as is the timeframe in which the various languages are introduced. In general, the languages would be the regional dialect pertinent to the school system—Hindi because it is the national official language, and English as a means to improve social mobility and compete in the workforce ( ).

Style

The term Hindi is ambiguous and therefore the source of much controversy because it is not easily defined. It is considered a regional dialect with a variety of common structural and interchangeable content elements. Its usage depends on both the regional affiliation and the social background of the speaker. Hindi is a highly open language closely related to other Indo-Aryan languages; therefore, the degree of stylization is determined by the degree of language-orientation consciousness in the speaker’s mind ( ). Hindi encompasses three areas of stylization: high, medium, and low. An individual may shift between high and low stylization according to situational requirements, as in formal discourse, during conversations with equals, and in giving instruction to subordinates.

Volume and Kinetics

East Indians are generally noted for their soft-spoken manner, almost considered mumbling by some. Frequently, head movements and hand gestures accentuate conversations, adding vitality to the speaker’s content. Men maintain direct eye contact with each other when conversing and may become loud and intense when addressing family members. Women usually draw their eyes downward when addressing their husband, father, or grandfather. This gesture demonstrates a sign of respect and should not be misconstrued as not caring or not listening ( ).

Touch

Displays of public affection are prohibited and viewed as disrespectful in the eyes of the gods. Married East Indian couples may show signs of affection in the privacy of their own home but not in view of children or elders. Affectionate touching or embracing among friends, relatives, and acquaintances is not a socially acceptable Hindu practice.

Implications for Nursing Care

The use of Hindi among East Indian Hindus is the one culturally unifying trait these people possessed after immigration to the United States or Canada. Reluctantly, East Indian Hindus have recognized the need for adoption of English as a communicative norm in the Western culture. Still, most elderly family members are unwilling to abandon the native language, which is regarded as meaningful to their cultural identity, and find it difficult to learn and communicate in English. On the other hand, younger family members, especially children, easily adapt to the Western culture and are more inclined to incorporate English into their language skills. Whenever possible, translators should be used by the nurse and other health care personnel when administering care to persons in the East Indian Hindu American population.

When obtaining a health history from an East Indian Hindu American client or family, both Hindi- and English-speaking family members should be involved. Because of uncertainty with the English language, the client may feel frustrated and not communicate conditions thoroughly. When a Hindi-speaking client becomes frustrated, the client may first attempt to translate needs by using Hindi; therefore, it may be necessary to translate Hindi responses into English. This process preserves the client’s cultural identity while promoting client confidence.

When interacting with recently immigrated traditional Hindu patients, it is important for the nurse to remember that it is considered taboo for a man other than the woman’s husband to extend his hand toward her in greeting. In introducing oneself to a female Hindu client, the greeting is first addressed to the husband or eldest female companion.

It is also considered taboo for a man other than a woman’s husband to initiate or maintain direct eye contact with a woman. This may be perceived by the husband as a seductive gesture. The wife, as a show of respect and out of fear of reprisal, may divert her eyes downward during conversation.

In today’s health care system it is imperative that practitioners incorporate cultural competency. In terms of the East Indian client, practitioners must consider and include complementary and alternative medications used by the patients; the way medical advice, instruction, and education has been understood or filtered by the prevailing cultural norms; and the impact of such on adherence of medication regimens and treatments. In addition, in terms of disability and death, practitioners must incorporate religious beliefs such as karma that help the patient in coping ( ).

Implications for Nursing Care

East Indian Hindus are a family-oriented people who do not view family as intrusive in personal space parameters. When an East Indian Hindu American becomes ill and is hospitalized, the entire family may gather at the bedside. Health care decisions are often made communally with the senior family member or the eldest son as the final authority ( ). Also, an important, highly valued role for grandparents is raising the grandchildren ( ). It is important for the nurse to remember that the client may feel that the space in the hospital is overextended and that the family’s presence is essential to collapse the space inward. In this case it is important for the nurse to involve family members in the plan of care and to ascertain which family members will provide personal care.

Family

In a traditional East Indian Hindu household, married sons live with the family under the parental roof and are subject to parental authority. Frequently the joint family includes approximately 25 individuals and may include up to 200 people. The average joint family is composed of six or seven family members, and the family may comprise several generations. It is of note that the average household size of the East Indian family residing in the United States is 3.0 ( ).

The patriarch controls the finances of the group, giving the sons allowances from their earnings. With globalization and the impact of the growing middle class, men are still considered the primary provider for the family. Thus, the primary role of men in these households is to provide financial income to support the family ( ). The matriarch is the autocrat of the home, and her daughters-in-law are subject to her rule. Although this system provides the members of the family with security and sustenance, it has been suggested that it encourages dependence and lack of initiative among many family members ( ; ). In the past, East Indian Hindu girls have wept at the prospect of marriage, not because of objections to little-known bridegrooms but in fear of their future mothers-in-law ( ). The joint family is a powerful social unit, whose pressures on the individual are greater than most Westerners can imagine. It has also been suggested that the East Indian family demands much sacrifice and devotion and consequently fosters timidity and lassitude in its members ( ).

The hierarchy of the joint family places the father or eldest brother at the highest level. However, the family relies heavily on a democratic system of governance, and decisions of prime importance are determined by a vote in which heads of family may be overruled. Although the head of the family (the patriarch) is the undisputed overseer of other male members of the household, the matriarch is responsible for the family’s female members and is instrumental in determining other domestic concerns. Modern East Indian women continue to be the dominant force in home life activities even if they enter the workforce and also provide income for the family ( ). Recent efforts to promote family planning to reduce the burden of the mushrooming population for the most part has resulted in action by women. Indian men appear to reject sterilization for both psychological and religious reasons, fearing it will destroy their male power or will interfere with God’s will ( ; ).

The East Indian Hindu father is perceived as being distant from his children, who prefer to bond closely with their mother ( ). The eldest son is destined to continue the family name and perform the holy death rites that will ensure peace for his father’s soul. This expectation places the eldest son in the position of being one of the closest family members to the patriarch. Throughout his life the eldest son, even when fully mature, rises when his father enters a room or is near him and greets his father with the pranām , the sign of deference in which one touches the feet of a highly respected figure. East Indian Hindus tend to be respectful of authority figures but are more distant with male superiors than with their female counterparts. These people cherish courtesy, which is reflected in the traditional greeting, wherein the head is bowed, the hands are clasped, as if in prayer, and the Hindu word namaste (“I bow to thee”) is uttered softly.

It is the family, above all other institutions, that is responsible for the implantation of social mores and values in the Hindu culture. Ancient traditions that are suggestive of the existence of external rituals are strictly practiced, and it is the adherence to these ancient traditions that determines whether young East Indians become conservative or rebellious ( ).

Marriage

In India, marriages of Hindu Indians have always been arranged by parents or other intermediaries. Because marriage was regarded as a union of families rather than of individuals, the marriage traditionally took place when the husband and wife were only children. In 1955 in India, it became illegal to arrange for the marriage of girls under 15 and boys under 18 years of age. This law has been amended in subsequent years to reflect the current legal age for marriage to be 18 years of age for girls and 21 years of age for boys ( ). However, this law is not easily enforced, and almost 60% of girls are married before they reach 18 years of age. Poverty is a major risk factor in the practice of child marriages. The National Family Health Survey from 1988 to 1999 found that up to 60% of girls were already married by the time they reached 18 years of age. Marriage at a young age brings about difficult challenges, such as financial responsibility, early and frequent pregnancies, and poor health ( ).

The long-standing practice of courtship rituals, which is primarily a Western phenomenon, is beginning to gain wide acceptance as traditional arranged marriages are being displaced. Now only the educated elite are able to personally arrange marriages, and these marriages account for less than 10% of the total marriages in India ( ).

The nuclear family, at 38.74%, is the predominant household classification type in India. Couples with married children and relatives residing in the home, termed extended and supplemented nuclear families, are also common. Males are overwhelmingly (91.2%) considered the head of household ( ).

East Indians have long considered marriage a financial and social arrangement designed to strengthen the position of the whole family, and traditionally one of the most important factors determining the choice of a bride has been the size of the dowry, that is, the property a woman brings to her husband at marriage ( ). In India, marriage proposals traditionally have been elicited through a third party who may or may not be a member of the immediate or extended family. In contrast to this, today in the United States, East Indian Hindus frequently place a classified advertisement in their search for a suitable candidate for a prospective bride or groom ( ).

According to , “The divorce rate is one of the lowest in the world” (p. 642). Because of societal pressures, the majority of married couples stay together even when there is dissatisfaction with their partner. Women are especially vulnerable to miserable, imbalanced, constricting, and even violent relationships. states that “it is not just the husband but also members of his family, especially the mother-in-law, who abuses directly as an oppressor or indirectly as an instigator” (p. 445). In Indian society oppression of women was considered the norm, and continued use of this oppression in a different social setting, such as in the United States, is thought to be “one way of recapturing a familiar primordial order in an alien setting” ( , p. 653). Thereby, acceptance of violence against women can be traced back to cultural beliefs.

Position of Women in the Family and in Society

In the past, East Indian women ranked far below men in social status. Marriage became obligatory because the unmarried woman was believed to have no place in heaven. Traditionally the belief has been held by East Indian Hindus that the role of a woman is faithfulness and servility to her husband. Because women were deprived of inheritance, a male descendent was essential ( ).

Traditionally, the wife had few legal rights and could not publicly contradict or challenge her husband. Mentioning her husband’s name in public was also not permitted. This taboo proved particularly confusing when she was required to identify herself for legal purposes ( ). Among the upper class in the Hindu communities of the northern regions of India and in some areas of southern India, many wives practice purdah, the anglicized form of Hindi parda, meaning “veil.” This tradition decrees that in public a wife hides her face behind a veil to ensure that she will be seen only by her husband. This custom is intended to protect her husband’s rights over her ( ).

Mahātma Gandhi was one of the first champions for women’s political and social rights in India. In addition, the Women’s Indian Association (1917) and the All-India Women’s Conference (1927) were organized to unite women in their quest for status attainment through education, social reform, and politics. The association and conference included political picketing and voluntary social work. Although the Indian women’s organizations provided tremendous support for the independence movement, it has been reported that they were unable to promote the essential issues related to women’s emancipation. It has even been alleged that these organizations were means of maintaining and gaining status to move into higher echelons of power and that only upper- and middle-class women benefited from them ( ). Cumulatively, change in the status of women in postindependence Indian society has been moderate and not far reaching in its influence; for example, the issues of marriage (particularly regarding the remarriage of widows), divorce, and property inheritance serve to illustrate the inequities still occurring in India where women are concerned ( ; ).

In concurrence with modern feminist movements throughout the world, a “sisterhood of women” hoping to establish “a global female community” is flourishing in the Indian province of the Madras presidency ( , p. 131). The goals of these women include improving literacy, abolishing caste traditions, and the option to delay marriage.

Caste Systems in India

For centuries East Indians have divided themselves by caste, by language, and by religion ( ). The Hindu population was divided into four váras (colors), which became castes ( Box 19-1 ). These segregated castes were the Brahmin, or priestly caste; the Kshatriya, or warrior caste; the , or trading and farming caste; and the Aasādra, or artisan caste. Approximately 60% of the population held membership in one of these four castes. Outside the caste system, another group of people were referred to as untouchables. Gandhi renamed the untouchables the Harijans or “children of God.” These people were the handlers of slaughtered animals, garbage, and the dead. Whereas the members of the highest caste, the Brahmins, were regarded as pure, Harijans were thought of as polluted and defiled ( ; ). See Box 19-1 for a description of each caste’s or noncaste’s role in Hindu society.

Box 19-1

From Spear, P. (1972). India: a modern history . Ann Arbor, MI: University of Michigan Press.

Caste System in India

• 1.
  

  Brahmins. The Brahmins (“possessing sacred knowledge”) were the priests and occupied a position of prestige and influence. These priests performed scholarly pursuits. The distinguishing color of the Brahmins was white.

  
  
• 2.
  

  Kshatriyas . The Kshatriyas were the warriors who in ancient times had been the head of society and later were ranked second to the priests. The color of their dress was red to symbolize their work of providing military and political leadership. Warfare was considered a duty of the Kshatriyas, and any hesitancy to fight, even against one’s own kin, was considered a violation of the dharma, or “law,” of the caste.

  
  
• 3.
  

  . The (“community men settled on soil”), who made up the largest caste, were involved in commerce. The ritual color of this caste was yellow. The members of this caste had the more mundane tasks of raising cattle, tilling the soil, shopkeeping, and lending money. Although the lacked the social, ritualistic, and political privileges associated with Brahmins and the Kshatriyas, they ultimately gained great power and wealth as a mercantile order.

  
  
• 4.
  

  Śūdras. The function of the Śūdras was to perform menial tasks for the higher groups. Most members of this caste were poor tenant farmers and artisans. The most the Śūdras could hope for was that they would be reborn in a higher caste. The ritual color of this lower caste was black.

  
  
• 5.
  

  Untouchables. Untouchables were not allowed to live within the boundaries of a community or to have access to the village water well. They had to perform those duties that were considered unclean, such as tanning leather, cremating the dead, and executing criminals.

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