Archive for October, 2012

Developing Deliberative Democracy in Jerusalem Neighborhoods – a case in Gilo

October 25th, 2012

A few months ago, in cooperation with the UJA – Federation of New York, we began a project to work with a number of community centers to assimilate principles of deliberative/ participatory democracy that respects all the different voices in the community (see a previous post on this). At the Gilo Community Center, which we have been in contact with for several years, this was an opportunity to show that it is possible to collaborate successfully on a large scale, and not just to organize mass impressive events that take months to prepare and 6 months to recover from (which we did a few years ago).

In some areas of Gilo one of the major problems was parking. There are 3 streets – DellaPergola, Hamechanechet and Baruchi – that are very problematic. People park there helter-skelter in the evenings, blocking others, and one must look for neighbors who will move their cars in order to leave the parking area. It is even dangerous – ambulances find it difficult to go into and leave the streets and it also creates a problem for public transportation – the buses just aren’t able to pass. In initial conversations that we had with the professionals in the Municipality, it seemed that nothing could be done and nothing could solve the problem. According to these professionals, there are not ways to change the situation – from their perspective, the residents just needed to stop blaming the community center and the Municipality…

The community center decided to have a residents meeting and asked us to help in the process. Our approach is that we mainly mentor the community center staff and probably facilitate the actual meetings. The community center staff does most of the outreach work etc., because in the end the community center needs to assimilate the deliberative democracy methods and it knows the situation in the field much better than we do.

The first meeting with the residents was fascinating. After we listed and documented all the relevant problems that the residents and professionals raised, we moved to suggesting solutions to the problems that were collected. It is important to note that because the professional staff (including the relevant regional planner and director) sat together in this meeting and discussed the issues, there wasn’t the regular “ping-pong dynamic” in which residents complain and professionals defend themselves. Solutions that the residents or professionals thought were potentially successful but not relevant – were discussed in a respectful manner (even though the atmosphere was tense and the manner of speaking was typically Israeli…). For example, a number of residents suggested cutting down the trees between the parking areas in order to create more parking spaces. The planning officials then explained that the present situation is actually the opposite – the parking spaces were planned first, and the trees were planted later, to fill in spaces not designated -or appropriate – for parking. Thus, removing trees would not solve anything.

But, to our amazement, several elegant solutions were raised that the professional staff did not think of at all and which did seem suitable. One of them, in the context of DellaPergola Street, was to designate parking spaces according to families and thus reserve at least one parking space for each family, and the rest of the automobiles would park in other parts of the street or on other streets. We won’t get into the technical details, but it turns out that the professionals did not think about this solution because they didn’t believe that the residents would like the idea, and in any case, they assumed that someone would object and would shoot it down.

The Gilo staff called a second residents meeting. After massive advertising of the outcomes of the first meeting (which is significantly important, because there were many who didn’t come to the first meeting because they assumed that nothing would be accomplished). We enabled the residents to respond in other ways as well – email, telephone, etc. In the second meeting a lot of points and hesitations were raised regarding the designation of parking spaces. Again, the to-the-point discussion amongst all present brought about a formula that works. After the meeting, the community center staff and the regional municipal planner and director progressed in the technical areas related to the designation of parking spaces, as well as in work with all the street’s residents. A number of residents went from house to house and explained the situation and helped to designate the free parking spaces. Slowly, in discussions with tenant associations and additional residents, a map of agreed-upon designated parking spaces was formulated. There were definitely some residents who were more difficult to please, but correct work by the residents solved the problems one by one.

And it is happening as we speak – there’s just been the first day of painting the parking spaces, and the second day will take place next week. We definitely see the success of the process.

From our perspective, this is a significant case in which we showed that residents, staff and officials can cooperate together, without getting stuck in objections and bureaucracy. We believe that more and more processes like this in Jerusalem will create a more respectful atmosphere between city residents of different identities, less alienation between the residents and the ‘establishment’, and especially a feeling that the residents can be partners in the successes in the city and enjoy them. There are other successes in Arnona, Givat Messua, Baka’a and beginnings in Gonenim and Romema – but we will talk about that at a different opportunity.

Assisting Medical and Paramedical Professionals in Receiving Certification from the Israeli Ministry of Health – an update and congratulations!

October 23rd, 2012

This is a follow-up to a previous post on this issue. Over the last year, in cooperation with the Jerusalem Foundation and the Community Services Division of the Jerusalem Municipality, we’ve been working to solve the both sides of the same issue regarding health care in East Jerusalem. On the one hand there is a severe lack of personnel in all disciplines that is certified to work in East Jerusalem. On the other hand, there are hundreds of graduates of academic programs, from universities in the West Bank or Jordan, who are living in East Jerusalem but are not able to work in their fields (or are working ‘under the table’ in those fields and are not receiving full salaries or legal benefits), because they did not pass the requisite certification exams given by the Israeli Ministry of Health.

We began this journey exactly a year ago, when we began to explore the issue in two disciplines: occupational therapy and nursing. We learned that the Ministry of Health needs additional Arabic-speaking workers in these disciplines, especially in East Jerusalem. We also learned that only 1-2 nurses and occupational therapists passed the exam each year.

We learned that the first problem was language – the graduates’ Hebrew was not good enough to pass the Hebrew exam, and that the Arabic translation of the exam was a very poor one. Moreover, all of the graduates had studied in English in their universities. Thus, even though it wasn’t their mother tongue, they preferred to take the exam in English. We then learned that the occupational therapy exam had become available in English two years previously, solving this part of the problem for them. In nursing, for some reason East Jerusalem residents had not been allowed to take the exam in English. We then met with officials from the Ministry of Health, who rather easily, agreed to let them take the exam in English as well.

With one obstacle behind us, we discovered that the graduates did not have access to the necessary learning materials – their own universities were far away, and only Hebrew University students have access to materials there and at Hadassah. This was actually very easy to resolve – we bought the books, and the graduates came throughout the year to study in our offices.

And then we discovered that there are occupational therapy materials that are only in Hebrew – position papers of the Occupational Therapists Association, as well as laws, which the students must learn. We translated these position papers into English and donated them to the Association’s web site. (We also received thank-you letters from other students in Israel who used our translations…) The laws were too complicated for us to translate, so we found a successful lawyer from East Jerusalem, who agreed to study the laws and explain them to the students, thus enabling them to learn the information.

We made contact with the relevant schools of occupational therapy and nursing at Hadassah, and convinced them to join our adventure. We then held a preparatory course in English for some 15 graduates in occupational therapy. On the day of the exam, which was held in Tel Aviv, we rented a bus for the participants. We didn’t want to take any chances of them being held up at security checks at the central bus station in Jerusalem. The result: 6 passed and became certified occupational therapists! Those who didn’t pass will sit for the exam at the beginning of November, and we’re keeping our fingers crossed for them.

In nursing, the story was much more complicated. The exam is very difficult, and the preparation requires thousands of practice multiple-choice questions on a number of subjects. The problem was that we didn’t have a reserve of questions that was suitable for the Israeli exam – Hadassah’s pool was entirely in Hebrew, and it would have been exceedingly expensive to translate them. Even proofing the translations would have taken forever. We dared to do something that many thought would not help – we used large question pools in English that are used for the American certification examinations (NCLEX-RN), which is different from the Israeli. At the end of each chapter, we gave the students a small number of questions in English, based on the Israeli exam. The assumption was that in the end it was the same ‘body’ of knowledge (with a number of differences in legal aspects and ethics and emergency room protocol and first aid), and even though the type of questions are different, this model helped. No doubt that we gambled on our unique approach – it turns out that no one remembers that there was ever a preparatory program for the Israeli nursing exam in English.

Before we began the nursing program, we gave a practice test to the participants and no one passed! That was our base point, quite frightening. During the course we gave another practice test in July, and 7 participants passed. A month later, 2 weeks before the official exam, we held another practice test and 12 passed. 12 new nurses in East Jerusalem, the number that usually passes in 8 years, is definitely an achievement, but we wanted more – there were 45 participants in the course! After the exam at the beginning of September, we waited and waited (it turns out that the Ministry of Health takes a month and a half to grade thousands of exams), and yesterday the results came in: 25 (twenty five) passed the nursing exam!!! More than 50% success rate! We are over the moon, I must admit. We really didn’t imagine in our wildest dreams that we would be so successful.

It is important to understand the significance of the success of the nursing program – a large part of the graduates have worked in East Jerusalem as nurses, but without certification, they could not legally perform many medical procedures. Many times they did those procedures anyway, because they had no choice, and without the enforcement of the Ministry of Health. Now, their status is different, and with justification – they learned so many essential things in the preparation program that were important to their work, regardless of the examination. By the way, their salaries are also supposed to jump significantly. So it is good for them, and it is good for the residents of East Jerusalem – who will receive better health care in the clinics and hospitals in East Jerusalem. If we continue this trend, the legitimacy for these institutions to employ uncertified nurses will decrease drastically.

What’s next? There are many things that must be done – continuing the same disciplines and creating a sustainable system of preparatory courses for certification, as well as entering into additional professions – physical therapy, speech therapy, and more. And maybe we’ll succeed in areas that aren’t in the field of health care? We’ll know in time.