Blog | The Jerusalem Intercultural Center

Turning the Tables on the Project Management Training for Multicultural Project Leaders: Participants Lead a Tour of the Multicultural Nature of Jerusalem

Yesterday we turned the tables on the Project Management Training for Multicultural Project Leaders, which is supported generously by the Rosenzweig-Coopersmith Foundation. This training is intended for Change Agents and Project Leaders in Jerusalem that are doing Inter-cultural work. It is an 18-week course that covers the principles of project management, effective activism, challenges of multi-cultural groups, and the special case of Jerusalem for all its residents.

On February 19, we took the entire course out on a tour of Jerusalem. But instead of us teaching participants, they themselves taught us. They were the tour guides, they were the experts. We, and everyone else in the course, sat back and learned.

This was part of the section of the course that dealt with Jerusalem. Other meetings on Jerusalem featured 3 different panels from Jerusalem’s 3 major population groups – one on the Ultra-Orthodox population, one on the Palestinian population and one on the non-Haredi Jewish population.

We went to all different areas in the city. We went to A-Tur, Beit Safafa, Jebel el-Mukaber and Silwan in East Jerusalem. Participants were shocked at the state of infrastructures there – the lack of sidewalks, the garbage, roads and signs in disrepair – all of the lacking infrastructure that they must deal with on a daily basis. In A-Tur we learned about special education in East Jerusalem. In Beit Safafa / Pat we learned about the Max Rayne Hand in Hand School for Bilingual Education, and its unique activities, bringing together Jewish and Arab children to study in the same classroom, in Hebrew and Arabic.

A participant from the Katamonim neighborhood told us about her community, a Jewish and economically disadvantaged neighborhood that is undergoing some urban renewal processes. She also spoke about the Ethiopian community there, of which she is a part. We also went to the German and Greek colonies, where we heard about those neighborhoods from a local artist, another participant. She showed us a street exhibition of several artists that her works were displayed in.

The Haredi (Ultra-orthodox Jewish) neighborhoods also left a strong impression. For many of the non-Haredi participants, Arab and Jewish alike, this was the first time they had ever ventured into these areas and taken a close look. We went to Sanhedria, to Romema, and other adjacent neighborhoods. We went past the Belz ‘castle’; we learned what a ‘Talmud Torah’ is, what a gmach is, what a mikveh is. Even the Jewish non-Haredi participants, who had heard of the terms, learned their meaning through the eyes of their fellow Haredi participants in the course.

Naomi Roff2014-04-04T12:57:51+00:00February 20th, 2013|Blog, Courses, Identity Groups and Conflicts, Inter-Cultural Community Dialogue, Jewish-Palestinian/Arab, Ultra-Orthodox Jews|

MiniActive – Weathering the Storm

We began the MiniActive program as a small, grassroots empowerment program. What we got was a social change empire!

Example: Last week’s winter storm. We don’t remember when we had such a storm. It had it all – heavy rainfall, strong winds, and, at the end, lots of snow. More importantly, it cause lots of infrastructure problems that stopped up the whole city. In East Jerusalem, because of appallingly poor infrastructures, apartments and houses were flooded, electrical and telephone lines were knocked down, and many streets were blocked because of fallen trees.

Floods outside the Old City

Enter the MiniActive women. They had already become adept at calling and communicating infrastructure problems with the municipal 106 complaint hotline. (See here) Many of them did not have electricity or telephones themselves. Liana, the coordinator, declared a state of emergency, dedicating the whole network to work to fix problems created by the storm. Five of them came to our offices on Mt. Zion to help Liana coordinate the complaints and handle the more difficult problems, and they went to work, utilizing the hundreds of women in the networks in the field.

Damage in A-Tur

And boy did they go to work! In a flurry of activity, they were in contact with the 106 municipal hotline, the electric company, the phone company, the water company. They became critical sources of information for these bodies. Our offices were abuzz from morning till night – with telephones, faxes, e-mails and Facebook posts – but most of the activity took place outside the office. On the day of the snow, Liana couldn’t get to the office. Instead she managed the whole operation via her iPhone. In just 48 hours the network reported 3,000 issues and tracked their resolution.

Ceiling of house that needed to be repaired

One case included moving a family whose house had been flooded and who has a handicapped son to a safer location. Another was making contact with the proper authorities for a woman in Abu Tor who was about to give birth during the snowstorm. (She was transported safely to give birth in the hospital.) A third was contacting the Municipality to deal with walls that had fallen into the street as a result of the storm. In yet another case families whose houses had been flooded were moved to alternative housing until they could return home. Without this information, the welfare department would have had had no idea how to locate the families.

Working to fix phone lines after the storm

We can only take our hats off to the MiniActive women, and thank them for their energy, persistence, and drive. Kul El-ihtiram! Shukran! (Bravo! Thank you!) And now, a glimpse of Jerusalem covered in snow:

Naomi Roff2014-04-11T16:02:38+00:00January 15th, 2013|Blog, Effective Activism, Identity Groups and Conflicts, MiniActive, Palestinians/Arabs|

MiniActive in East Jerusalem and beyond – meeting with the municipality hotline

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.

jicc2017-05-05T13:58:47+00:00November 25th, 2012|Blog, Effective Activism, Identity Groups and Conflicts, MiniActive, Palestinians/Arabs|

Developing Deliberative Democracy in Jerusalem Neighborhoods – a case in Gilo

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.

jicc2014-04-11T15:52:04+00:00October 25th, 2012|Blog, Deliberative Democracy, Gilo Community Dialogue, Inter-Cultural Community Dialogue|

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

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.

jicc2014-04-11T15:42:01+00:00October 23rd, 2012|Blog, Cultural Competence, Cultural Competence in Health Services, Education, Employment, Employment Accessibility, Identity Groups and Conflicts, Palestinians/Arabs, Supporting employment in East Jerusalem|

Developing Deliberative Democracy in Jerusalem Neighborhoods

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.

jicc2014-04-04T12:57:04+00:00July 3rd, 2012|Blog, Deliberative Democracy, Inter-Cultural Community Dialogue, Inter-Cultural Community Dialogue Course, On Jerusalem|

Professional Development for Healthcare Cultural Competency Coordinators from around the country – Final report

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:

Virginia Tong, Vice Presidents of Cultural Competence, Lutheran Medical Center, New York
Young Lee, Director of Training and Development, Coney Island Hospital, New York
Branka Agic, PhD., Manager, Health Equity Center for Addiction and Mental Health (CAMH), Toronto, Canada

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.”

jicc2017-05-26T20:05:38+00:00May 21st, 2012|Blog, Cross-Cultural Communication Trainings, Cultural Competence, Cultural Competence in Health Services, Outside Jerusalem|

Professional Development for Healthcare Cultural Competency Coordinators from around the country – Summary of Day One

We’ve taken yet another step in becoming one of the national leaders and reference points of Cultural Competency in the health care system in Israel. On Monday, 23 April we held the first meeting of a professional development seminar cultural competency coordinators from around the country. This is the first such seminar ever to take place in Israel! Our 16 participants included representatives from the major hospitals in the country: Hadassah Medical Center and Sha’are Zedek in Jerusalem; Shiba-Tel Hashomer and Sourasky Medical Center in the Tel Aviv area, Rambam in Haifa, and more.

We have been working to advance cultural competency in the health care system in Israel since 2007, and we are in constant contact with most of the cultural competency coordinators around the country. Most of these coordinators have been appointed since the publication of the Ministry of Health’s Cultural Competency Directive, published in February 2011, that will require medical interpretation services, education and training of medical staffs, environmental adaptations of all health care institutions by 2013. As a first step, the Directive requires health care organizations to appoint a cultural competency coordinator to be responsible for all the processes that work toward equal cultural and linguistic accessibility for all.

Our unique seminar is taking place in cooperation with the Ministry of Health and is a natural continuation of the Directive. The training will provide knowledge and tools to enable cultural competency coordinators to assimilate the Directive in their institutions. It is important to note that most cultural competency coordinators are already in senior management positions in their organizations.

The 5-day training seminar, which will meet weekly until the end of May, will include 50 hours of frontal lectures as well as a webinar with cultural competency coordinators from Canada and the USA. Our funders for this course are the Jerusalem Foundation and the New Israel Fund. The course is being held at the Nursing School at the Tel Aviv Sourasky Medical Center.

The training course will cover:

• Introduction to Cultural Competency: Medical interpreting and translation and mediation in health services, models of intercultural communication between patient and caregiver, cultural dimensions in interpersonal communication, dealing with political and social tensions, different cultures’ approaches to health and sickness, and more.
• Practical guidance for cultural competency processes in health care organizations – from the cultural competency coordinator’s first steps to full organizational adaptation.

It will also include guest lectures on the following subjects:

• Inequality in the health care system and the role of the cultural competency coordinator in reducing gaps.
• Acquaintance with the main theories of cultural competency in Israel and around the world.
• Tools for implementing principles of cultural competency in a health care organization.
• Tours of hospitals and clinics that are undergoing cultural competency processes.
• Clinical aspects of different cultural approaches to sickness and health.
• Culturally-dictated social norms.
• Cultural competency from the viewpoint of health organization administration.
• Cultural competency from the viewpoint of social organizations dealing with community health.

The opening lecture was given by Dr. Emma Averbuch from the Unit of Decreasing Health Inequality at the Division of Health Economics and Insurance Division of the Israeli Ministry of Health. Dr. Averbuch emphasized the importance of the cultural competency coordinator and how he or she can contribute to decreasing inequality in health care. She also surveyed the Ministry’s activities thus far in advancing cultural competency and decreasing inequality in the system.

Prof. Leon Epstein speaks on Inequality in Health at the Cultural Competence Coordinators training

The participants also had the first session covering the “Guide for Cultural Competency Processes in Health Care Organizations”, which is a practical guide we developed over the past 2 years. It details the steps that must be taken to assimilate cultural competency principles in an organization. This meeting concentrated on defining the role of the cultural competency coordinator, as well as first steps in creating a suitable buzz within an organization for cultural competency. In addition, the participants related their experiences with the community, and the discussion that followed focused on the need to establish and expand these relationships to be helpful in times of crisis.

Part of the training included a practical exercise in creating change. Each participant was asked to choose a small initiative that is related to at least one component of cultural competency that he or she wanted to change by the end of the training course at the end of May. This initiative needed to be something easily implementable and with high visibility in the organization. Participants chose projects such as mapping needs and resources, linguistic accessibility of restrooms, and more.

Simulation of a case of cultural competence at the training

Two guest lectures dealt with the relationship between risk management and cultural competency, from Ronen Regev-Kabir, Deputy Director, Public Trust organization, and Netalie Goldfarb, the Care Competency Unit of the Ministry of Health. Our own Dr. Hagai Agmon-Snir closed the day with a workshop on cultural dimensions and the main values of interpersonal communication, to give a taste of the cultural competency workshop that will be the focus of the second workshop on 30 April.

In parallel to this meeting, an Internet discussion group was established that will deal with cultural competency in the health care system in Israel. There will be participants from within and without the health care system and it will enable participants to share knowledge in this area. You can view the discussion group and the course’s accompanying materials here.

jicc2014-04-11T15:37:13+00:00April 23rd, 2012|Blog, Cross-Cultural Communication Trainings, Cultural Competence, Cultural Competence in Health Services, Outside Jerusalem|

Assisting Paramedical Professionals in Receiving Certification from the Israeli Ministry of Health

Here’s an example of how our work in one area uncovers more and more needs in East Jerusalem, and opens up more opportunities to begin to close the gap in services to Palestinian residents of East Jerusalem.

We spent a long time working toward the opening of a Well-Baby Clinic in Silwan in August 2011. While working on the issue of opening more clinics, we discovered that there was a severe lack of Arabic-speaking nurses who were certified by the Israeli Ministry of Health. It meant that these Well-Baby Clinics in East Jerusalem and other healthcare institutions find it hard to find good certified nurses. The employment authority of the Municipality looked into the matter, and discovered that the problem was much larger – in general there is a dearth of Arabic-speaking medical and paramedical personnel, certified by the Israeli Ministry of Health, in East Jerusalem.

We also discovered that there are hundreds of graduates of Palestinian universities and colleges in the West Bank (for example, Bethlehem University, the American University of Jenin), who cannot work in their fields in the Israeli healthcare system. These institutions are considered ‘overseas’ institutions, and graduates must pass Israeli Ministry of Health certification and competency exams. (Israeli graduates must pass these examinations as well.) Very few Palestinian graduates from East Jerusalem pass these examinations. Paradoxically, the Israeli Ministry of Health is eager for these graduates to find work in the Israeli healthcare system in East Jerusalem, to reduce the above-mentioned lack of Arabic-speaking medical and paramedical professionals.

A preparatory meeting of nursing school graduates in East Jerusalem

A preparatory meeting for nursing school graduates in East Jerusalem

The Jerusalem Foundation, our long-time partner in creating cultural competence in the city and in creating better opportunities to all in the city, asked us to enter into the picture. Much of the initial work was investigative: we first sought to figure out the real obstacles that prevented Palestinian graduates from passing the examinations, and then proposed responses. At the outset we chose to concentrate first on occupational therapy and nursing. As part of this extended learning process, in November 2011 we held public meetings for each of the professions, which included relevant information about the certification process. Most of the participants had previously failed the exams, and they became integral partners in our learning process of constructing a full picture of the current situation.

The results were fascinating – and yet, typical – of many of the difficult problems that we have encountered, whose sometimes solutions were relatively simple. Indeed, we find many times that what looks as huge barriers can be overcome by simple solutions. Let us share these results and the response we suggested with you:

In occupational therapy, it turns out that until very recently, the exam was available only in Hebrew and in Arabic. Yet, the problem was that the Arabic translation was very poor, which hurt candidates’ chances of passing. More importantly, at Bethlehem University and at the American University in Jenin, the students learn in English! Thus, they would be much more comfortable taking the exam in English. Fortunately (unrelated to our work), in the past year students have been able to take the certification exam in English as well.

But this was only the beginning of the story. We discovered that part of the required material for the exam included position papers in occupational therapy that exist only in Hebrew; knowledge of Israeli laws, which is also available only in Hebrew; and the guidelines for occupational therapy in Israel, which exists in Hebrew, Arabic and English, but that the students knew nothing about! In other words, the Palestinian graduates were sitting for exams, for which they did not have access to or did not even know about significant parts of the material. Many graduates received scores between 50 – 60 (passing is 60), and this is without knowing about a good deal of the required materials.

This information enabled us to respond quickly. We translated the position papers into English (the language preferred by the graduates for the exam); we obtained guidelines for occupational therapy in Israel in English; with assistance from the Hebrew University Hadassah School of Occupational Therapy, we developed a program to prepare graduates for the exam that will take place in June 2012. This program began a week ago with 17 dedicated participants. The course will include 11, 3-hour meetings as well as 2 concentrated days as the exam nears.

Our follow-up is both group and individual – we purchased occupational therapy textbooks that are important for the exam, and participants will be able to use these materials. We helped each and every one of the participants register for the exam with the Israeli Ministry of Health, and more. We are very optimistic, but we will of course be calmer after the results of the June 2012 exams are released…

The situation in the field of nursing was more complicated. Here, too, graduates from East Jerusalem could take the exam in only Hebrew or Arabic, with very poor achievements (1-2 graduates passed the exams each year). The exams themselves are considered difficult – many graduates of Israeli universities also fail the exams each year. After a meeting with the Ministry of Health, it was clarified that from now on it wouldn’t be a problem for East Jerusalem residents to take the exam in English. Thus far we’ve given some 50 nursing school graduates a pre-test, similar to the real examination, to find out what we need to concentrate on in the course. We identified that 20 received between 50 – 60 on the pre-test (60 is the passing grade). This result encouraged us, since the graduates didn’t have much time to study, and if such a large group is so close to passing, the chances of at least 15 passing the certification exams in September after a program of intensive preparation and study, are good. In addition, we learned from the exams on what areas we need to focus more in the preparations.

Based on this information, a preparatory program for Palestinian nursing school graduates is being developed to prepare them for the government exams in September 2012. It is important to note that those who pass the nursing examination in a language other than Hebrew must also pass an additional exam in Hebrew language in order to receive a license to be a nurse in Israel. Yet, the Ministry of Health allows East Jerusalem residents who passed the exam not in Hebrew to work in Palestinian institutions in East Jerusalem. This means that those who pass the exam would only be able to work there. Although there is also a severe lack of personnel in East Jerusalem, we hope to provide participants in this course with Hebrew instruction, so that they will be fully qualified to work in nursing, anywhere in the healthcare system in Jerusalem.

We will be following these women and men through the examination and (hopefully) placement process. We hope that at the end of this process we will not only helped dozens more people receive employment in their chosen professions, we will help more of the 280,000 Palestinian residents of East Jerusalem receive better health care.

jicc2014-07-11T09:19:43+00:00April 15th, 2012|Blog, Cultural Competence, Cultural Competence in Health Services, Employment, Employment Accessibility, Identity Groups and Conflicts, Palestinians/Arabs, Supporting employment in East Jerusalem|

The JICC in Sefad at the Ziv Medical Center

Even though the JICC is focusing on the Jerusalem area, we find more and more cases in which the expertise we gained in the city is important in capacity building in other places. One example was today, when some 20 members of the senior administration staff of the Ziv Medical Center in Sefad gathered for a unique workshop on cultural competency, facilitated by the Jerusalem Intercultural Center (JICC). The workshop was organized by Dr. Sarah Nissim, Deputy Director of the Nursing School and Cultural Competency coordinator for the hospital. Dr. Nissim had asked the JICC to present cultural competency to the senior managers, before they began to assimilate the principles in the hospital. Sarah, who is a veteran colleague of the JICC in cultural competency, sought to engage the JICC to facilitate the assimilation of cultural competency principles in the hospital, as per the Ministry of Health directive, in the 2012 work year.

Dr. Shapiro Klein, Deputy Director of the hospital and Dr. Sarah Nissim (Cultural Competency coordinator) began the workshop with opening remarks.

The JICC in Sefad at the Ziv Medical Center

At the beginning of the day the participants shared their experiences of intercultural encounters in the different departments. Thus, for example, one person detailed the difficulties dealing with a Druze girl with an eating disorder. Another doctor spoke about the difficulty working with the Haredi community and its rabbis, despite the dialogue that takes place from time to time between local rabbis and medical staff. We saw the huge difference between the Jerusalem hospitals that deal with diverse communities within the Jerusalem region, as opposed to Ziv, which deals with diverse communities over a vast area (mostly the upper and eastern Galilee and the Golan Heights), which requires a different type of communication with the different community heads.

As such, the first ‘theoretical’ part of the workshop dealt with tools and ways to bridge the gaps between cultures. These tools followed a clarification of the concept of ‘cultural dimensions’, and an analysis of dialogues between patient and caregiver in which different cultural values are presented.

The second part provided practical tools for professional medical interpretation, as well as practical suggestions on how to relate to non-professional interpreters, through movies and analysis of case studies, from Israel and around the world. Immediately after lunch the participants practiced their knowledge of intercultural issues – a specially-trained actress played a Haredi and Palestinian patient in two separate scenarios.

Role play

This workshop was used as a kickoff to the process of assimilating cultural competency principles into the hospital, which will be led by Dr. Sarah Nissim. Part of the plans discussed with her include a workshop for bilingual staff members to overcome the communication problems with the Ethiopian community and training of facilitators from among the hospital staff to establish a set mechanism of training medical staff at the Ziv Medical Center in Sefad.

jicc2014-04-11T15:30:21+00:00March 26th, 2012|Blog, Cross-Cultural Communication Trainings, Cultural Competence, Cultural Competence in Health Services|

Previous 535455 Next