Just now, The Jerusalem Intercultural Center’s Facebook page has passed 10,000 likes!
10000 likes!!
We’d like to say “thank you” to all our fans and supporters, and hope that together we will make Jerusalem a more hospitable city to all the people who live in it! It’s a real challenge for such a city, but there is only one Jerusalem – so we must make it happen!
Yours,
The JICC staff and volunteers
This summer, Kikar Zion (Zion Square) in Jerusalem became a hot spot of xenophobia. It was not the first time for the Square, but this new wave began after the kidnapping and murder of three Jewish boys in June 2014. Nir Hasson reported in Haaretz on July 1, 2014:
Since the discovery of the three Israeli teens’ bodies on Monday, tensions have been rising between Jews and Arabs in Jerusalem with several assaults reported overnight. On Monday evening a spontaneous vigil was held in Zion Square, where people lit candles, prayed and sang. Yet on the sidelines of the vigil groups, young people gathered and began marching through the center of town yelling “Death to terrorists” and “Death to Arabs.” Most of these groups dispersed before any violent incidents occurred, mainly because many Arab workers were away for Ramadan. However, several assaults were reported overnight.
Interestingly, as documented in Hasson’s quote above, there were others, mostly students, who came to the exactly same Square to mourn and spread an alternative option for tolerance. These activists continued to come to the Square in the following months. In mid-August, we at the JICC decided to help this spontaneous group. While keeping it independent of any formal or organizational connection, we began to help in logistics, in convening meetings of the activists, in professional consultation. And yes, some of us became part of the group as activists… Hagai Agmon-Snir, the JICC director, wrote a Facebook post about his all-night experience at the Square.
Following the above Facebook post, Nir Hasson decided to come to Zion Square to write about it. He published the article in Haaretz on September 12, 2014 (Acrobat version) and the article was translated into English by Haaretz and was published in this version the following day (Acrobat version).
Here is the full text of the article:
By Nir Hasson | Sep. 13, 2014 |
Every Thursday and Saturday night, Jerusalem’s Zion Square becomes a scene of confrontation. On those evenings, activists from Lehava – an organization whose name is a Hebrew acronym for “fighting assimilation in the Holy Land” – gather in the square, dressed in black shirts emblazoned with the words “Jewish honor guard,” to hand out fliers bearing slogans like “don’t let your daughters work with Arabs” and “don’t buy from stores that employ your enemies.”
After midnight, the black-shirted activists dismantle their unauthorized booth and begin to disperse, and police presence thins out. That’s when things turn violent: Youths harass passersby, attack taxi drivers and interrogate couples to determine whether they are Arabs or Jews.
Facing off against the racism, for the past two months, have been two different groups. One, which calls itself City Guard, is composed of veteran left-wing activists and sees its mission as protecting the victims. If their very presence doesn’t deter attacks, they will call the police and even physically interpose themselves between assailants and their prey. They start work around 1 A.M., when the Lehava activists begin to disperse and when people start spilling out of nightclubs, often drunk and ripe for violence.
The second group is more diverse, comprised of religious, secular and formerly religious students, mostly from Jerusalem but some from West Bank settlements. They see their job as trying to persuade the Lehava activists that racism is wrong, or at least to mitigate the violence.
Lehava activists have been instructed by the organization’s leaders not to get into debates with the students, but most ignore this order. The arguments often turn into cussing matches and even shoving spats. But occasionally, they manage to spark serious discussions about Judaism, nationalism, racism and human rights.
This summer’s war in Gaza and the rioting in East Jerusalem have been good for Lehava, turning it from a marginal group into a proud organization with hundreds of activists in many cities. Its Facebook pages may have been taken down, but it gets plenty of media coverage, which reached a peak three weeks ago when Morel Malka, a Jew who converted to Islam, married Mahmoud Mansour, an Arab.
Its opponents say Lehava is the wellspring from which violence against Arabs in Jerusalem flows.
Ofek Birnholtz, a doctoral student in physics, is one of the founders of the group of students that tries to reason with Lehava members. Last Thursday, he had a long and stormy discussion with one activist about Judaism’s attitude toward the stranger. “I won’t convince him,” Birnholtz admitted, “but maybe I’ll make him think a little more. The very fact that we’re here creates a dynamic of less violence and more dialogue. It’s a holding action.”
Hagai Agmon-Snir, director of the Jerusalem Intercultural Center and another member of the dialogue group, added, “When we talk with these teens, they insist they aren’t violent and aren’t coming from a place of racism or hating Arabs, that they just oppose assimilation. I’m not so naïve to think there’s no racism there, but this says it’s important to them to remain within the camp that says it’s not racist, and that’s a thread we can work with.”
Yovel Zim, a religious Jew from the settlement of Tekoa, said the Lehava activists “find it harder to deal with people like me. They immediately brand me as a leftist or say I’m not really religious because according to the Torah, all Arabs are enemies.”
But the one who annoys the Lehava members most is Yuval Ben-Ari, who insists on telling them about both his Arab roommate and his army reserve service. “I’m here because I returned from 35 days of reserve duty and heard that friends of mine had been beaten because they’re leftists,” he said.
One night, a Lehava activist tried to make him leave, shouting, “You’re nothing; you’re a wretch; you don’t care about anyone; you’re a disgusting egotist!” Soon Anat Gopstein, the wife of Lehava founder Benzion Gopstein, chimed in. “You don’t look to me like someone who does reserve duty and cares about the state,” she said. “You act like a sick person, a deviant.”
The harsh words aren’t unusual. Shoving ensued on the night in question, and the students say they are sometimes spat at. On one occasion a lit cigarette was thrown toward one of them. Nevertheless, they persist.
‘Authorities turn blind eye’
Some within the second group, the so-called City Guard, view the students’ efforts as wasted. Others even claim that their attempts at dialoge legitimize racism.
“It normalizes the situation,” says Eyal, a Jerusalemite and a co-founder the Guard. “You see the dynamic: There’s a booth that distributes racist flyers, and it’s surrounded by people who are standing around and talking like everything’s fine.
“There should be more physical resilience, awareness must be raised to make the authorities wake up,” he added.
Both groups agree that Israel’s authorities and mainstream society are turning a blind eye to racist activity.
“These days, shouting ‘death to Arabs’ in the middle of Jaffa Street is okay; nothing should be done about it,” Aviv Tatarsky says wryly.
“We shouldn’t be here,” adds Eyal. “We should be in East Jerusalem, shouting ‘occupation, occupation.’ The mainstream groups should be here – the youth organizations, city workers, and the police. But no one is here. Except for Reuven Rivlin, who spoke out, everyone is silent.”
According to Eyal, “Arabs are scared to walk around here … and the vast majority is willing to accept this.”
The municipality’s helplessness is evident as it disregards Lehava’s illegal booth, the leftist activists say. The dialogue group had asked the city to dismantle the stand early in the evening and was promised that action would be taken. Yet four hours later, no official had arrived on the scene.
The municipality, however, denied failing to enforce the law. A spokesman acknowledged that the booth was set up without a permit, but claimed the city had it dismantled immediately. The booth’s operators were informed that they must receive the city’s authorization to set up the stand, as well as for the content of the flyers it distributes. If they set up the stand again without a permit, it will be confiscated, according to the spokesman.
Both groups were founded on the evening that three Israeli teens who were murdered in the West Bank were laid to rest – hours before the murder of a Palestinian teen, Mohammed Abu Khdeir. On that day, a rightist demonstration turned into a series of violent acts targeting Arabs in Jerusalem’s center. Two days later, a leftist rally gathered in a Jerusalem plaza known as Cat Square to protest the violence. Some 1,000 activists arrived at the demonstration, organized by the Tag Meir organization. Once the speeches were over, the protesters quickly dispersed, to be replaced by Lehava activists.
“They started yelling ‘death to Arabs,'” recalls Birnholtz. “The [protesters] left and the city was once again forsaken, and we knew that we had another long night ahead of us.”
Neighbors. Neighbors can be a problem, even in the best of communities. But what happens when neighbors move in who are very different from you? Or when old-time neighbors’ families grow and grow, and seem to be taking over the very nature of your neighborhood? From the ‘other’ side – you’re just looking to living in a nice neighborhood with your family – what’s all the fuss about?
This has been the dynamic in two Jewish neighborhoods – Rehavia and Kiryat Hayovel – that we’ve been working in recently. Both are traditionally secular / national religious neighborhoods – in fact, they’re considered bastions of these populations in Jerusalem. Recently, Kiryat Hayovel has seen an influx of new Haredi residents. In Rehavia, there has always been a Haredi community, but in recent years more and more Haredi families were getting in the neighborhood, changing the demographics. In a city where the Haredi population is growing quickly and non-Haredi populations are feeling threatened, this can definitely cause tensions.
However, if one of our goals is to work to preserve a diverse Jerusalem, tensions are the last thing we need. So in an effort to assuage building tensions between the Haredi and non-Haredi residents of Rehavia and Kiryat Yovel, and thanks to the support of the Jerusalem Foundation and the UJA-Federation of New York, we’re working with 2 very special neighborhood forums.
In Rehavia, we’re working together with the local community council with a group of 20 Haredi and non-Haredi residents, many of them are the leaders of their communities. This includes a fascinating combination of young and older people, national religious, as well as Haredi and secular, men and women. By the end of the second meeting we’d come up with a Summary of Principles for working together. This of course doesn’t mean that individual – and sometimes far-reaching – issues have been solved. But right now we’re focusing on the ‘how we handle issues’, before we move on to the ‘what is the solution’. This includes sometimes basic statements, such as ‘live and let live’, ‘mutual respect’, ‘love of the neighborhood’ and an ’emphasis that we’re all one people’. But we all know that when tension threatens to boil over we need simple, basic principles to guide us through. This group has met twice, and will continue to meet. It has been decided to significantly expand this forum, so that broader agreements can be made and more people and groups can be represented.
In Kiryat Yovel the situation is a bit different. The entrance of Haredi families, even as a small percentage of the population, has raised numerous battle cries against the ‘Haredization’ of Kiryat Yovel, which arises in various forms from time to time. The group in Kiryat Yovel is still smaller – 8 people, all are main leaders – and thus far the two meetings have consist of ‘getting to know you’ conversations. Yet, because Haredi-non-Haredi relations are much terser than in Rehavia, the very existence of these meetings is of utmost importance. While Kiryat Yovel is a tougher nut to crack, we believe we’re on the right path, creating a safe haven for dialogue and conflict resolution. In the last meeting, two Neighborhood Council members hugged each other at the end. This was an unusual occurrence, since one was Haredi and the other was secular who is very active against the Haredization of the neighborhood. “Finally, here, I can give you a hug,” said the Haredi Council member. Another, a secular woman, requested that Haredi women come as well, so that she wouldn’t feel lonely. Currently there is no other place this could happen.
In both neighborhoods, there is energy to continue the processes, and a feeling of hope that is very important for the future of these communities, as well as for Jerusalem.
We’re feeling a bit of parental pride these days. With assistance from the UJA-Federation of New York, we’ve been working intensively with residents in the Talpiot – Arnona area in methods of deliberative democracy. The goals – engage residents in their community, enable them to take ownership of their community, making it a place they want to be, and stemming years of negative migration of Jerusalem’s young families and professionals.
When we began, the Arnona-Talpiot area was officially part of the Greater Baka’a Community Council catchment area. However, residents did not cross Derech Hebron to the main Community Council facility to receive services, nor did the Community Council staff make efforts to include Talpiot-Arnona residents in its activities. From a community standpoint, it was dormant – no community events; its commercial centers were quiet, barren places; no more than 3-4 children were found in playgrounds at one time.
Last fall we began working with the Community Council, the newly-elected neighborhood committee members from the area, and interested residents. We helped them form several task teams that concentrated on bringing about practical change throughout the neighborhood in a number of areas: the environment, public spaces, Jewish-Arab coexistence, local security, forming community gardens, and more.
This activity seemed to wake up the community, and developments were quick to come. This process had given residents a chance to take responsibility for their neighborhood, to influence the public sphere, to initiate projects, to become a part of the decision-making process, together with the Community Council, and they scooped up the opportunity. The original task teams bore additional ideas for action, which, in a period of only a few months, led to the idea of a huge, neighborhood-wide event, open to the entire city, celebrating Arnona’s 90th anniversary. The fact that the event grew from idea to fruition in only a few short months – returning vibrancy to the neighborhood – is a tribute to the transformation that has taken place over the past year.
Entertainment for the whole family in the commercial center
The positive ripple effects were felt near and far. Residents rallied to the cause. Institutions, organizations, businesses and local artists – all wanted to be a part, to contribute to help make the event an amazing one. Their reward – a renewed sense of community in Arnona, a feeling of pride and solidarity.
The afternoon – evening of May 23 was chock full of events, from the fairs and performances in the neighborhood commercial center to community garden to Shai Agnon’s house to exhibits in artists’ homes, to tours of the community. (Click here for the event’s web site in Hebrew). “We are happy to invite you to a community event, the product of the community processes we held over the past year,” reads the invitation’s accompanying letter. “Over the past months we have held a number of meetings with residents in which task teams were formed that deal with many areas. [That’s where we came in, by the way.] We are surprised to discover how diverse and how many community institutions there are in the neighborhood…We invite everyone, children and adults, to participate in the event and to enjoy a wonderful chance to start on a new path in the neighborhood.”
Arts and crafts in the commercial center
We can safely say the event accomplished its goal. People came out from their hibernation, met friends and neighborhoods, got to know a little about the neighborhood in which they live. The commercial center has never seen so many people. People attended the artists’ open houses, as well as tours of the neighborhood. Indeed, the feeling of pride and excitement – and a new beginning – was palpable at all the event venues.
Residents, together with institutions in the neighborhood and staff from the Community Council, were the ones who did all the work. But we’re still taking kvelling rights on this one, and we’re proud of our part in the process.
Performance in the community garden
Americans do it; Europeans do it; even some South Africans do it. But how do Israelis do it? How do Israelis make their health care organizations culturally competent?
We’ve been training health care staff in cultural competency since 2008, and the Ministry of Health has more recently begun training, in light of the Ministry’s 2011 Directive on Cultural Competency. But what’s been missing has been a guide that spells everything out, which coordinators can refer to once they’ve finished the training courses. One that provides the internationally-tested standards of cultural competency, adapted to the unique makeup of Israeli society and everyday Israeli reality.
We are now in the final stages of such a handbook, our Manual for Integrating Cultural competence in Health Care Organizations. This manual is not only the first of its kind in Israel to deal with cultural competency for health care, it is the first of its kind in Israel to deal with cultural competency in any discipline. It is one of our dreams to bring culturally competency approaches to other areas of life in Jerusalem and throughout Israel – from local and national government offices to the police to other public agencies.
As part of the development process for the handbook, on 22 April 2013 we held a day-long seminar for 30 cultural competency coordinators from major health institutions, as well as others who work and research the field, around the country. Our goal for the day was to improve the handbook and to learn from the many people who are already working in the field in Israel.
We were pleased by the diverse turnout. Some had taken our training course, some had taken that of the Ministry of Health, and others had taken neither. The variety of institutions represented was also rather wide: Sheba-Tel Hashomer and Tel Aviv Sourasky (Ichilov, where the seminar was held) hospitals in Tel Aviv, Rambam in Haifa, both Hadassah hospitals in Jerusalem, as well as hospitals in Tiberias and Sefad; four of the eight mental health facilities in Israel; Ministry of Health; Israeli HMO’s; and independent consultants.
Throughout the morning, we got down to work. We utilized the ‘world café’ deliberation method, with one moderator at each table, each table focusing on a different subject from the handbook: from language accessibility, evaluation and making the workplace accessible, training, and definition of the role of the cultural competency coordinator, to the first 10 steps of cultural competency. The groups discussed each area, commented, made suggestions, and brought up new ideas regarding this part. After some time, participants chose another topic, but the moderators stayed in place. In all, we made such 3 rounds, and we discussed the main suggestions and understandings in the summary session.
All told, we came away from the seminar rich in knowledge that will help us to update the handbook. And the participants were quite enthusiastic about the meeting as well, as a number expressed their desire to continue these professional encounters. “This encounter was very important,” said Maya Tzaban, from Poriyah Hospital near Tiberias. “Now I see that we are not alone, added Varda Stenger from Sheba – Tel Hashomer, “that we are a network, and can work together.”
Indeed, although we’ve held encounters with coordinators who’ve taken our courses, and the Ministry of Health has held encounters for graduates of their courses, this is the first time that all cultural competency coordinators have come together for peer discussion, learning and action as a professional network. In light of the feedback, preliminary plans are underway for follow-up meetings.
Additional take-away suggestions included:
Feedback on the manual in general was also very positive. Participants commented that that it helps to give a full picture of cultural competency and initial steps of implementation. They were also eager to provide feedback to refine the document. “I have the time and I’d love to give my input,” said Anat Revach, from the Jerusalem Center for Mental Health. “I want to be part of this process.”
About two weeks ago we brought together the director of the 106 municipal hotline, as well as some hotline workers, and about 20 leaders of our MiniActive groups, mostly from East Jerusalem.
In order to fully understand the importance of this meeting, we need to first explain what MiniActive is.
The process began several years ago, when we first became interested in activism in Jerusalem in the context of the different groups in the city and their ability to influence the public sphere. As we became more and more familiar with the field we got the impression that too much activist activity we saw was not effective. People go to demonstrations that people hardly know about, and return home with the feeling that they’re activists. People sign petitions that don’t lead anywhere and feel that they’re activists. People ‘like’ causes on Facebook and feel that they’re activists. In too many cases, the only result of an ‘activist’ protest is that one day the participants will be able to say that ‘we were there and we were right.’ But we are interested in activism that causes social change and too often activist action doesn’t lead to this. We tried, in our JICC meetings, to get to the root of what makes activism effective – that which causes social change – and we came across a number of insights. We even prepared a lecture on the subject. But then it became clear that there is nothing less effective than a lecture about effective activism….the message was seemingly projected, but it did not significantly influence those who are listening to the lecture.
Last year’s summer protests brought us back to the subject. And then, from conversation to conversation a new idea was born: a workshop that we call “MiniActive“. At its core is a group of a number of people (today we know that the most effective size of the group is 5. But this might change), and each one is to choose a personal challenge that he/she is passionate about and has taken responsibility to resolve. This challenge must have a decent chance of being achieved within a time frame of 4-6 weeks. This enables each participant real feedback in a reasonable amount of time to examine what works and what doesn’t work for him to achieve his specific goal. An additional condition, in order to increase the activist learning curve, is that in order to resolve the challenge, other bodies or people must be engaged (the municipality, the post office, the neighborhood grocery store, tenants’ association, etc.) A diet is undoubtedly an important challenge…but it is not appropriate for a MiniActive workshop because there is no learning that deals with influence on a social system or on other people. On the other hand, a MiniActive challenge could be to fix a broken street lamp, cause garbage to be collected, enable an area to be exterminated against fleas or rats, fix an unsafe handrail in a neighborhood school, teach a teacher that yells in school to talk more quietly, show a tenants association how to function well….etc. etc. A MiniActive challenge can be all the little – but important – things that we complain about but no one ever takes up the gauntlet to solve.
Within the framework of the workshop, the group meets every week (here too, there are variations), and each person gives an update on what is happening with his or her challenge. The fellow participants are supportive, make constructive suggestions, and mainly, laugh together. Yes, laugh. Today we know that the social side is critical here. It greatly helps if the meeting looks like a social get-together, people sitting around and shooting the breeze and talking about their problems. But we don’t get stuck in the complaining stage. In addition to creating functioning MiniActive workshops, our fantasy was that the graduates of the workshops would establish additional groups and lead them themselves, with a little bit of support and consulting. And of course, some of the graduates would do more and more MiniActive projects and even ‘graduate’ to Midi-Active and Macro-Active…
So we began, and it wasn’t as simple as it sounds. We learned that it works better when the group is ‘next door’ and / or when the group works in the same geographical area, so that beyond the learning experience, one can really see the differences that occur in that area, simply because 5 people caused them to happen. But the pace of the development of the MiniActive approach was not yet impressive.
And then Liana Nabeel from A-Tur in East Jerusalem entered into the picture and began working at the JICC. We were introduced to Liana through her participation in our Project Managers Course last year. The course included, as one of its parts, a MiniActive workshop, and Liana just completed the MiniActive challenges too early – i.e., from meeting to meeting – so that each time she needed to choose something else. We quickly brought her on board to the JICC, to the East Jerusalem Desk that Ezadeen Elsaad manages. The main challenge that we gave her was to establish MiniActive groups of women in East Jerusalem. We might not have explained it well that we meant 5-6 groups…
Within a few months, 35 – 40 groups were started throughout East Jerusalem, with 180 active women! Liana proved that beyond her activist abilities was her ability to maintain large groups of volunteers. Thus, in Wad Kadum (between Silwan and Jabbel Al-Mukaber) streets are now lit at night, garbage is being picked up more regularly and new garbage receptacles have been put in place. In parts of the Muslim Quarter of the Old City, the phone company, after decades, has fixed exposed and dangling telephone lines. (The electric company in East Jerusalem is our next challenge). In Wad Al-Joz, there were exterminations against fleas and rats, and the water company is beginning to take care of sewage and drainage problems…Just two days ago, potholes were fixed in Silwan, an initiative of the MiniActive women. A significant part of the groups were established by graduates of the first groups and are facilitated by them. And everything is done in a supportive, social atmosphere, a camaraderie of women. It sometimes angers the active male residents when they discover that their meetings, which include the community leaders, accomplish less than the energy that the women’s MiniActive groups create.
One of the important principles that we speak about is that in order to reach solutions effectively, one doesn’t necessarily need to fight the other side – people are surprised every time to discover good people who are willing to help on the ‘other’ side – in the Municipality, in the telephone company, etc. Because the Municipality’s 106 hotline (the equivalent of th American 311) is often the first step in taking care of a large part of the issues, it was important that the hotline would not see these women as annoyances, and that the women did not see the operators as the enemy who doesn’t want to solve the problems. The 106 hotline in Jerusalem is unique in Israel, having technology and work procedures that helps in municipality response to residents calls. It was important to create an encounter that would be the basis of a worthy relationship between the callers and the operators. In addition, if there were communication difficulties – there would be a way to fix them quickly.
As a reminder, we once helped this 106 hotline recruit more Arabic-speaking workers, but some recently left (this is expected; it is a job suited to university students), and there is again a shortage of Arabic-speaking operators at the hotline. Liana solved the problem with a unique solution – she would call the hotline in the morning to see if there is an Arabic-speaking operator, and if so, she would text all her participants that this is a day to call. We are of course helping again in recruiting workers, since a lack of Arabic-speaking operators is a difficult obstacle for these women, who really don’t speak Hebrew.
So, as we said, on Tuesday there was a meeting of MiniActive group leaders (about 20). They also included some from west Jerusalem, but much fewer than those from East Jerusalem. It was also an opportunity to thank the American Center in Jerusalem that helped in the process of creating the MiniActive Program. It was a meeting with a slightly unorganized, energetic dynamic – partly because it was necessary to translate everything between Hebrew and Arabic and back again, partly because the activists continued to try to solve more and more problems such as broken stairs in the Muslim Quarter. (What can you do? Once an activist, always and activist…) But in the end we achieved the result we set out to accomplish – enabling the activists and the operators to get to know one another and paving the way for an even more effective ability to stimulate change.
MiniActive project meeting at 106
In the days following the meeting, we noticed a significant change in the dynamics with the 106 hotline. If there were additional hiccups in communicating with the hotline they were solved quickly. The energy of the women in the groups and the effective activism they demonstrate In the past few days are creating solutions to many issues in their neighborhoods.
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.
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.
Over the past few months, thanks to support from the Commission on the Jewish People of the UJA – Federation of New York, we’ve been working with a number of neighborhoods in the city in order to encourage and to operate processes of community dialogue and deliberative democracy.
Together with professionals in the community centers and councils, we are planning and developing processes that are adapted to the characteristics of each neighborhood’s population and to the specific issues each neighborhood is most concerned with. Our goal is to bring all the voices of all the different identities in the community to be part of a decision-making group and to enable each resident to advance ideas and initiatives that are important to him.
In each neighborhood the process is taking on its own identity, and each neighborhood is focusing on different issues. Below are a few examples of the work we’re doing:
Creating a set space for discussion and entrepreneurship. In Givat Massua (part of the Ganim Community Council) and in Arnona (part of the Larger Baka Community Council) we hold open meetings each 5-6 weeks. In these meetings, residents and community professionals raise issues connected to the public sphere (in every field: education, culture, physical development, early childhood, youth, etc.) that they are passionate about advancing. Residents come together, hold discussions, think creatively of initiatives to address the issues, and, together with professionals who are part of the discussion and the action, advance their ideas toward implementing change.
Some of the meetings concentrate on a single issue – such as youth – and discuss a number of sub-issues connected with it. For example: informal activities for youth, education for youth, youth at risk, Parents Patrol to prevent at-risk behaviors among youth, and more.
Solving problems or resolving conflicts in the public sphere, where there is a conflict of interest between residents who live in close geographical proximity (same street, neighborhood, complex), regarding an issue affecting the joint living space. For example, disagreement regarding the use of a structure, parking arrangements, rules of conduct in a public space, and more. In this situation we bring together all the stakeholders in order to raise all the needs and interests of all the sides, and we create a process of in-depth discussion and agreed-upon alternatives to deal with the conflict. One example is the process of engaging residents in solving the problem of parking on a street in the Gilo neighborhood. There is a street where there are a lot of parking problems. Some residents wanted to dedicate the parking on the street only for residents, or for paid parking, to ease the problem. Others, who had more than the allotment of cars, didn’t want the street to be designated parking. What do we do? Do we designate the street or not? Do we designate part of the street and leave the rest untouched? Meeting of residents helped to formulate remedies that are now being implemented, with the help of professionals.
In Talpiot there is a similar type of discussion over the use of a public building. The significant community of Ethiopian Jews in the area want to make an available public building a synagogue for the Ethiopian community; others want to turn it into a youth club. In the end a compromise was reached – the Ethiopian community received permission to pray in the building, while their own synagogue is being built for them.
Planning processes or building vision – in cases in which there is a need or opportunity to bring together the community to hear the different desires, positions or needs and to galvanize positions, goals and visions for the entire community to work toward. For example, there was a need in the Baka neighborhood to create agreement between all the different stakeholders on the desired direction of the planning and physical infrastructure in drawing up a new master plan for the neighborhood. Such a process enables us to envision our ideal future and to figure out how to take steps to realize this ideal state. In the process we learn, have in-depth discussions, build agreement, think creatively and develop alternatives to dealing with conflicting desires. A similar process is beginning around planning the land use of the main entrance to the Gilo neighborhood. Here, the Municipality allocated a sum of money to plan and develop the entrance to this southern neighborhood. This is a long strip that borders the Beit Safafa neighborhood. Instead of just developing the area, the Municipality is engaged in a decision-making process with the residents, involving them in discussions and making them partners in action.
Engaging the Community Council Board in community dialogue – a series of encounters between the JICC and representatives of community council boards. These are elected representatives and we work with them to learn how deliberative democracy and representative democracy can work best together. As a part of it, we create a new model of work for such boards – based on passion and resposibility in task forces, rather than ineffective committees.
In parallel to all these processes, we are holding professional development seminars for community centers/councils professionals (community workers, planners, project coordinators, absorption coordinators, youth coordinators, and more) who work in the neighborhoods. They themselves represent the diversity of Jerusalem – Haredim, religious and secular; religious and secular who work in Haredi neighborhoods. The goal of the seminar is to contribute to their knowledge of community dialogue and deliberative democracy. We currently have 18 participants, even though we originally aimed to have 11 – 12. We’ve had 2 out of a planned 5 meetings, and it has been absolutely amazing!
In this training seminar the participants are introduced to the approach of community dialogue and to the theory of deliberative democracy, as well as to leading models and principles of community dialogue. They received tools to help them implement deliberative processes in the neighborhoods, and developed their ability to act in complex situations in the community. Throughout the program, which includes a series of meetings from May – November 2012, each participant will lead a process of community dialogue in his or her neighborhood, with our mentoring and consultation.
On May 21 we finished the first professional development seminar for 17 cultural competency coordinators in Israeli health care organizations. They came from hospitals such as Hadassah, Shiba-Tel Hashomer, Sourasky Medical Center, Rambam, and more. For some this was their first step in the cultural competency process of their respective organizations. The seminar included 5 meetings and a webinar with cultural competency coordinators from the US and Canada. For a link to the post on the opening of the seminar click here.
From the third meeting: panel of hospital directors – from Sheba, Alyn and Bikkur Holim – and the role of management in cultural competence
The Tour of Cultural Competency in Action The fourth meeting was an all-day tour of cultural competency in action in Jerusalem. The first stop was at the Alyn Rehabilitative Hospital, which began its cultural competency process in 2007. Mrs. Naomi Geffen gave us a tour of the different departments and clinics, explaining the main issues, such as translation in medical and educational settings, ensuring patient and caregiver are the same sex in some cases, dress code, separation of boys and girls in the therapeutic pool, adapting the rehabilitation process to the patient’s culture, and more. Participants also visited the Muslim prayer room that was established in cooperation with the JICC and community members two years ago. We also received examples of materials and documents that had undergone linguistic and cultural adaptations, from a therapy schedule in the patient’s language, the internet site, release letters, and more. We were all amazed at what was accomplished here – today, hospital staff speak in a new language, one that is more advanced and without stereotypes. The second station on the tour was a well-baby clinic that provides services for the Ultra-Orthodox Jewish (Haredi) population in Meah Shearim. We met the clinic’s manager and a leader from the Toldot Aharon community, which is considered to be one of the more conservative and separatist divisions of ultra-orthodox Judaism. The clinic and its services have undergone a process of adaptation to the needs and approaches of the Haredi population, facilitated by the JICC, which included adaptation of the physical environment (pictures, brochures in Yiddish), training for nurses about how to appropriately approach mothers, and more. We intervened, with the full cooperation of a leader in the Haredi community, after a serious epidemic of whooping cough and measles in the Haredi community that spread because of a low rate of immunizations. We discussed with them a number of issues including: vaccinations and immunizations, developmental delays, and more. We also heard about a unique project for first-time mothers, and the special adaptations that had been made for the Haredi community. The third stop was Hadassah – Mount Scopus. Ms. Gila Segev gave an overview of the project that began in April 2010, just as she was appointed cultural competency coordinator. Gila recruited volunteers who were trained in verbal translation/ interpretation by the JICC and lecturers from the Department of Translation and Interpreting Studies at Bar Ilan University. Because 60% of the hospital’s patients are Arabic speakers it was decided to concentrate on Arabic. We also heard a first-hand account of the Hebrew – Arabic translating / interpreting process from a volunteer. The visit concluded with a panel of representatives of different communities to learn about the needs of patients and how to work with the different communities successfully over the long term. The panel included: Dr. Itchik Seffefe Ayecheh (from the Tene Briut organization that advances the health of Ethiopians in Israel), who felt that the focus should be on training and workshops for the medical staff to understand the importance of the relationship with the communities. Dr. Meir Antopolski (“Meeting Point” organization whose goal is to create a new cultural space for the Russian sector) who believes that the linguistic dimension is a critical obstacle in the relationship with the communities, and Mr. Fuad Abu-Hamed (who operates Clalit Health Services clinics in East Jerusalem) gave a fascinating overview of the Palestinian communities of East Jerusalem.
The panel with the Russian, Ethiopian and Palestinian community representatives
Webinar The webinar was on May 16, focusing on the experience of 3 cultural competency coordinators from abroad. Some of the speakers are full-time cultural competency workers with staffs dedicated to responding to the multicultural needs of patients, from special menus and food preparations to organizing different cultures’ holiday celebrations and commemorations. All speakers presented a model that many of the participants could strive toward. The speakers included:
A snapshot from the world cultural competence coordinators webinar
Summing Up The fifth meeting featured a discussion about socio-political tensions that affect the patient-caregiver relationship and how the caregiver and the cultural competency coordinator can relate to it on an organizational level. One example was of ongoing discussions amongst the staff on social-political tensions, with an understanding that these tensions are not limited to the patient-caregiver relationship, they are also found between staff members, which also requires special attention. Later on, Dr. Anat Jaffe from the Hillel Yaffe Hospital in Hadera, and one of the founders of Tene Briut, spoke to us. Dr. Jaffe surveyed the medical meeting point from an inter-cultural perspective. In her lecture she focused on her dealings with the Ethiopian community and diabetes, from her expansive experience as a doctor in the community and in the hospital. The final meeting also included presentations of the pilot initiatives that participants worked on during the seminar. For example, representatives from the Western Galilee Hospital in Nahariya created and passed around a mapping and evaluation survey of different cultural and linguistic aspects of their patients. The representative of Bikkur Holim Hospital in Jerusalem is making the hospital’s voicemail system accessible in 4 languages, and the representative of the Italian Hospital in Nazareth changed the internal signage in the departments to 3 languages. Ms. Avigail Kormes from the New Israel Fund closed the course with warm remarks and wished them success.
For an article in Hebrew in Ha’aretz newspaper by Dan Even 4 June 2012 click here.
A translation from Ha’aretz article :
The Era of Multiculturalism Reaches Israeli Hospitals
The hanging of pictures on the wall of non-blonde children, the creation of prayer rooms, and the translation of discharge papers into French – these are the new practices in hospitals of a new policy that requires cultural competency. In February 2013 a new Ministry of Health directive goes into effect requiring cultural competency in Israel medical institutions. As part of the directive, each institution is required to appoint one member of management to be in charge of cultural competency, who will be responsible to implement the new practices. Initial training sessions for coordinators in the past month reveal that the process does not include merely cosmetic changes, such as posting direction signs in Arabic, but seeks to change the atmosphere in the entire hospital to make it accessible to the multiple cultures in the state, especially during a period in which the social fabric of the country creates endless difficulties. One of the organizations that began training cultural competency coordinators is the Jerusalem Intercultural Centre (JICC), that has been advancing this topic in the capital’s hospitals since 2007, with the support of the Jerusalem Foundation and the New Israel Fund. This month the JICC held a course training for for 17 cultural competency coordinators from 14 hospitals at the Schoenbrun School of Nursing, Tel Aviv Sourasky (Ichilov) Medical Center. According to Dr. Hagai Agmon-Snir, the director of the JICC, “cultural competency is more than signage and the translation of forms. Patients need to receive all the medical services of the facility in a way that is accessible both linguistically and culturally, whether that means adding foreign language newspapers to the waiting rooms or making the pictures on the department walls more culturally applicable. When the pictures on the walls only portray blonde Dutch children, it’s most problematic, and its important to include pictures of children from diverse backgrounds, so that people will feel as much a part of the place as possible.” One of the issues that the JICC seeks to integrate in this new process is accessibility of diverse religious and cultural services in the medical facilities. “Opening prayer rooms for different religions is not a political matter, but a professional one,” says Agmon-Snir. Muslim prayer rooms currently operate in only a few hospitals in the country, including Rambam, Alyn, and Hillel Yaffe. “In every self-respecting hospital in the West it’s customary to address diverse religious needs. It appears that addressing religious needs favorably influences the medical treatment, and it is important to advance this in Israel as well,” says Agmon-Snir. Cultural competency also includes the correct usage of terminology that is sensitive to different cultures. Especially now, when social tensions are at their peak, whether related to the ultra-Orthodox, foreign workers or African immigrants, it is incumbent on medical staff to exercise more sensitivity. “It’s important to know the appropriate terminology for each culture. When dealing with the Haredi population, modesty in speech is required. In the ultra-Orthodox community, for example, it’s not customary to says ‘kaki’ or ‘excrement.’ One also has to know how to relate to rabbinic opinions which may influence the type of treatment, just as one has to adapt to secular patients who come to the doctor with information they have gotten on the internet.” Sensitivity to concepts is also required for immigrant workers. “In our training we teach how to be sensitive to every culture, even to the foreign patient from Eritrea,’ says Agmon-Snir. “In some cultures, for example, ‘no’ is not a firm refusal, but rather a request to hear more information before making a decision. In some cultures, when a patient bows his head he is showing respect for the caregiver, and it is not at all a refusal of care.” Another course for coordinators responsible for cultural competency coordinators from 24 hospitals began this month, under the auspices of the Ministry of Health, via Dortal Consulting. According to Dr. Emma Auerbuch, coordinator for reducing gaps in health care for the Ministry of Health, “Our approach is a little different. For example, anything related to places of worship, in our opinion, is the decision of the administrator of the medical facility, and should not to be imposed from above. In all matters related to cultural accessibility, one must remember that it is the goal of health facilities to provide medical treatment, and we try as much as possible to avoid tension.”
The different approach between the bodies can also be found with regards to the translation of patients’ forms. The JICC seeks to translate all the forms a patient might receive, including discharge papers, into various languages.. Auerbuch stresses that “the directive requires translation only of forms that require a patient’s signature, but we won’t prevent a hospital from offering translations of other forms as well. Recently a health fund in Netanya began offering medical information in French, since there is a large concentration of French speaking immigrants there. We can only congratulate them for that.” The courses include among other things training in preventing social tensions during the medical treatment. “This is an especially relevant topic in Israel, because people here tend to cross the lines between professional and political. Many times a patient will tell a doctor or a nurse what he thinks, for example, ‘you’re Russian and that’s why you act that way.’ The intercultural contact creates a challenging dynamic, including the use of stereotypes, and medical staff must learn how to maintain professional interaction, as much as possible,” says Agmon-Snir. “One must remember that the patient’s welfare is paramount, and the role of the health system is not to educate the patients. It’s not the doctor or nurse’s job to teach the patient manners or how to behave. A nurse may certainly put a disrespectful patient in his place, but in a professional context. Saying to a patient, ‘you Ethiopians are always late’ is not appropriate. Special attention is being given to emergency rooms. According to Dr. Agmon-Snir, “Although the pressure in the emergency room complicates the ability to give a patient detailed explanations, sometimes investing three extra minutes in explanations can save confusion and much time later on.”
