Cross-Cultural Communication Trainings

“The Resident at the Center” – Empowering City Center Residents through Deliberative Democracy

For more than two years we’ve been using deliberative democracy methods to foster a sense of community and belonging among Jerusalem’s diverse populations, thanks to the generous support of the UJA-Federation of New York. We’ve been working with a number of Jerusalem neighborhoods, from Gilo and Baka’a to Romema, Kiryat Hayovel and Rehavia, as well as in regional (Jerusalem Railway Park) and citywide initiatives (training of community workers).

Open Space in City Center

Open Space in City Center

The latest neighborhood to embark on this process of empowerment is the City Center. As part of a community-building process that began in March of this year, on December 1, 2014, some 200 residents squeezed into the gymnasium at the Experimental High School in downtown Jerusalem for a town meeting based on Open Space Technology. The group was incredibly diverse – Ultra-Orthodox, Secular, Conservative, Reform, Orthodox, immigrants from all around the Jewish world, and even a few asylum seekers from Eritrea! Three elected City Council members, one of them a Deputy Mayor, joined the group and later joined the task teams.  All came to discuss issues in the neighborhood that they were passionate about finding solutions for.  For the first time, residents were excited to finally be able to give voice to their everyday concerns, and meet other people who were potential partners in finding solutions. Examples included noise, sanitation, parking, quiet on Saturdays, improving safety, the elderly, growing plants in the city center, ecology, and more. These 200 people split up into different task teams, and we will continue to mentor them to ensure that the issues are advanced.

According to the residents, this is the first time ever that residents have been led in any community-building process in the downtown Jerusalem. Until now, many felt that they were “transparent” in relation to the business-owners in the city center, and that their needs were secondary to the businesses’. They’d tried to organize themselves around different issues (planning Nevi’im Street, the pedestrian malls, and more), but there was never an organized, long-term process that allowed residents to have their own say in the future of their neighborhood. We see this as just the beginning, and are going to help the groups that were formed to continue to work and impact downtown. We truly believe that this is a new beginning for the residents of the City Center.

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The JICC Calming the Waters in this Time of Crisis

garbage-cans-full1It’s been a difficult few weeks here in Jerusalem and in Israel in general. First the kidnapping and murder of 3 Jewish high school boys who had been studying in a yeshiva in the West Bank, then the kidnapping and murder of an Arab boy in Jerusalem, which sparked demonstrations in Jerusalem and even throughout Israel. And then missiles and air strikes and increased fighting.

We have been working to ease tension and conflict, and to promote civil engagement in Jerusalem’s future, since we were established in 1999. Thus, when tensions heightened and reached breaking points, we were there, trying to help residents re-gain order, first in their everyday lives, and then on a community and city-wide level.

Over the past few weeks we’ve played a key role in Jerusalem. We helped to spread a message of calm and a return to routine, through our broad network of contacts throughout the city.  In consultations with key figures we advised using a range of methods that successfully brought quiet to the streets relatively quickly. These consultations also returned routine services – garbage collection and sanitation, for example – back to the residents, reinforcing the feeling that everyone wished to get back to normal as quickly as possible.

garbage-cans-full1

It seems that these actions – and the influence of their messages – proved true in the field. Shuafat, the neighborhood where Muhammad Abu Khdeir (the Arab boy who was kidnapped and murdered) was from, became completely quiet during the day and incidents at night decreased quickly as well. Outbursts of violence and vandalism in different Arab neighborhoods were handled similarly, with similar calming results.

As soon as the military activity began in Gaza (July 6) and the missile attacks throughout Israel, including Jerusalem, we moved into a different mode of operation. We summoned the independent Emergency Readiness Networks that we helped to establish in East Jerusalem, which are a central component of the readiness of East Jerusalem in any emergency situation (from the snow storms in December 2013, to potential rocket fire like there is today) , and they continue to be on alert today. We are also helping many community councils in west Jerusalem that needed help in responding to the current crisis. For example, in the Greater Baka’a Community Council we helped to draft information and special messages of calm from the Community Council, which offered volunteer psycho-social professionals to help neighborhood residents. We advised other community councils regarding their responses to the situation as well.

In addition, because of our deep and extensive work in cultural competency in the health care system, we prepared special guidelines for health care workers for when social and political tensions are high, as they are now. In more normal times, hospitals and health care systems are often rare examples of coexistence and cooperation – between Jews and Arabs, religious, secular, ultra-orthodox (Haredi) Jews, etc. However, in times like now, when tension is palpable throughout the country, the situation inside hospitals and other health care institutions is affected as well. Indeed, in the past, there have been numerous instances of verbal and physical violence within hospitals, between patient and caregiver, between patients, and in rare cases, between caregivers. The guidelines help to delineate a professional response to prevent these situations and to deal with them quickly and effectively when they occur.

While today most of the attention is not on Jerusalem, we continue to work hard to maintain an everyday routine – and quiet. Under the circumstances it has become a state of “Emergency – Routine”. Much of the work continues to rely on the MiniActive and Emergency Readiness networks. The Emergency Readiness Networks continue to be on alert, ready to spring into action if necessary. The MiniActive groups continue, especially now, to contact service providers and report problems and demand repairs and improvements, which are able to take place because of the relative calm in the city. A lot of the work is being in contact with as much of the network as possible; the situation is not easy for any Jerusalem resident. Both Jews and Arabs are feeling the polarization and tension in the air.

Let’s hope for better times to come, soon.

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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

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

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

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.”

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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

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

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.

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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.

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Cultural Competence and Mental Health – Beginning to work with the Jerusalem Center for Mental Health

We are on the verge of yet another transformative process in the field of cultural competency. On March 14 – 15, the JICC was invited to present its introductory cultural competency workshops to 70 senior managers from the Jerusalem Mental Health Center, at its annual management conference at the Dead Sea. This Mental Health Center includes hundreds of staff who are responsible for 300 hospital beds (active and extended stay departments) over 2 campuses (Kfar Shaul and Eitanim), Mental Health Centers in west and south Jerusalem, in Ma’ale Adumim, Mevasseret Zion and in Beit Shemesh. The Center also serves the Arabic-speaking population from East Jerusalem. The focus on cultural competency at the annual conference is a kickoff to the process of making the Jerusalem Center for Mental Health culturally competent. The Jerusalem Center was the first mental health center in Israel to commit, through the JICC help, to assimilate principles of cultural competency throughout its system of care.

Mental health services are a special challenge for cultural competency, since most care is based on verbal communication. At the same time, it is important to note that public mental health services are required comply with the Ministry of Health directive (February 2011) on cultural competency, as other health care organizations. In this conference the issue was introduced to the senior management, including department directors, as well as those in key roles, before cultural competence is being assimilated in all departments. The spotlight given at the conference is the result of many meetings between the JICC and the Jerusalem Center administration, as well as with the Jerusalem Foundation, to explain its importance in psychological care.

Practicing Dialogue

Throughout the first day the participants told stories about intercultural challenges and events they had encountered. In addition, Dr. Hagai Agmon-Snir, JICC Director, presented a workshop on intercultural communication and cultural dimensions and how awareness of this subject influences mental healthcare.

During the second day the participants were exposed to the importance of professional interpreting in therapy sessions, and shared examples, from Israel and around the world, of therapy being compromised because of language barriers. Senior staff understood the need and seemed willing to change the existing situation (which today uses non-professional and unskilled interpreters) to make the services more accessible. The day included a fascinating discussion about the boundaries of multiculturalism (“How much should I give up my professional and personal values in order to adapt the therapy session to the patient that comes from a culture that is entirely different than mine?”).

Workshop of the Jerusalem Center for Mental Health March 15, 2012

It was obvious that the 2 days of the conference were a first taste, and that this will be a long process that will require close cooperation between the JICC and the Jerusalem Center for Mental Health. The process will include training the medical and administrative staff in CC skills, and training bilingual staff in a medical interpretation, as has been done in other Jerusalem hospitals (Bikur Holim, Alyn, Hadassah) and HMOs. We believe that the products of this lengthy process can be a prototype for similar accessibility processes in other mental health centers around Israel.

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Ethiopian Community, Talpiot, May 13, 2009

A month ago, we updated on our efforts, together with Mosaica, to train establishment agencies, such as the Community Council, the Welfare Department, the Absorption Authority etc., to work with the Ethiopian community in the Talpiot neighborhood. Since then, we met again with representatives from the community, from organizations that advocate for them and from establishment agencies.

Some of the Training Participants

Some of the Training Participants

Today we held the first cultural competency training for representatives of agencies that work with the Ethiopian community, focusing on cross-cultural communication. We learnt about the communication style of Israelis and compared it with the communciation style of Israeli-Ethiopians. In fact, Israeli-Ethiopians tend, as all multi-identity individuals (or, in other words, every individual…), to use both systems of communication, even though they seem to contrast with each other.

Dr. Hagai Agmon-Snir at the training

Dr. Hagai Agmon-Snir at the training

We invented a case study specifically for this training about an Ethiopian community leader who gets in conflict with the establishment over community issues. It was striking, but not surprising, to see how much the participants identified with the case study, feeling that the story resembles many of the incidents they encounter daily. We began analyzing the case and many issues were raised. On our next meeting we will have to think about solutions – how does one crete a bridge between these two cultures.

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Lod – Cultural Competence Training to Service Providers

As an outcome of the work of Lod’s Multicultural Forum, a first training on cultural competency for service providers has begun. This is probably the first training of this kind at the national level.

Today’s meeting, the first in the series, was facilitated by Najuan Daadleh and hagai Agmon-Snir from the JICC. The meeting with attended by 15 participants coming from various departments of the Lod municipality, the local employment service, non-profit organizations, community centers and more.

The first two meetings focus on cross-cultural communication and an introduction to cultural competency. Additional meetings will provide models for better communication with a client of a different cultural background, using interpretation, adapting a service to various client groups, and other relevant topics. Case studies and simulations will enhance the learning process.

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Ethiopian Community, Talpiot, March 12, 2009

We continue with our efforts, together with Mosaica, to create better dialogue between the Ethiopian community in Talpiyot and the many agencies that serve them. Although some achievements were made (reported in previous posts), the  main difficulty of lack of trust and understanding still persists.

Today we (Mosaica and the JICC) had a meeting with most of the establishment agencies, community council, welfare department, absorption authority etc., were we presented our analysis of the situation, including three major challenges. According to our analysis the main problem is the proliferation of agencies that work with the residents concurrently and with no coordination between them. This can be harmful in any place, but it is worse when serving the Ethiopian community, which finds it hard to navigate the Israeli system. The second challenge is the cross-cultural communication, which is not working well due to the different value systems of the cultures involved. The last pressing issue is the tendency of the Ethiopian community to attribute the behavior of the agencies to racism. The fact that almost all professional staff members are not Ethiopian, and that they have never learnt how to work with the Ethiopian community, does not make the situation easier.

Our suggestion was to provide cultural competence trainings to the agencies that work with the Ethiopian community, as well as train the community leaders to deal with the agencies who serve them. We are pleased to report that the agencies accepted our proposal and a few dates were secured for trainings. In parallel, we will meet with the leaders of the Ethiopian community to talk with them about this new proposal.

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Fourth Training to Municipality Absorption Neighborhood Officers

On February 18, we held the fourth training in the series that provides the Absorption Officers at the municipality with an introduction to the field of Cultural Competence.  The series covers topics such as organizational cultural competence, cross-cultural communication, tools for cultural competence, case studies and simulations.

In the workshop we learnt about medical models for inter-cultural dialogue with patients. Based on these models we formulated tools adequate to the needs of absorption officers and other service providers in their work with new immigrants. Special emphasis was given to political issues and inter-group tensions that are raised during meetings of the absorption officers with their clientele.

The absorption officers will examine the tools at work and during our next meeting in April we will conclude the discussion about the usability of such tools. In the last workshop in the series we will also focus on the role of these professionals as cultural competence agents in their neighborhoods.

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