Cultural Competence in Health Services

Celebrating a Decade of Cultural Competency: New Practical Uses for Old Traditions: The Ethiopian Case

It’s incredible that we’ve been leading efforts to increase cultural competency for the past 10 years. To celebrate, as we’ve described here and here, we’re hosting a series of lectures in partnership with the ALYN Rehabilitative Hospital and the Jerusalem Foundation. The latest lecture was on Monday, October 15, 2018. In honor of the upcoming Sigd Holiday, which will take place on November 7, the lecture focused on the source of the holiday, and enabled a closer look at different traditions that the Ethiopian community in Israel brings to society. This community had been disconnected from the rest of the Jewish world for more than 2,000 years until coming to Israel, and still preserves its ancient traditions while also developing new ones.

Yuvi lecturing

Yuvi lecturing

The lecturer was Ms. Yuvi Tashome-Katz, who was born in Ethiopia and came to Israel via Sudan. Today Yuvi is a social entrepreneur and activist, with twenty years’ experience in community work and counseling, and today is a member of the southern city of Gadera’s city council. In recognition of her social activities, Yuvi was chosen to light one of the ceremonial torches on the 2011 Independence Day celebrations. Later that year she was awarded the Prime Minister’s Prize for Initiatives and Innovation and the Matanel Prize for Groundbreaking Leadership.   

Lecturing to a full house

Lecturing to a full house

In addition to the Sigd holiday, Yuvi spoke about how women learned about womanhood and parenting from the ‘Women’s House’ – a place women stayed during ‘menstruation holiday,’ as well as for 40 days after birth. From a young age teenagers were shown how to care for babies, nursing, and more. Children were taught to strengthen their abilities, and tasks around the house and in the fields were assigned according to their abilities. In addition, information about medicinal herbs, nutrition and other health-related issues was passed along orally from one to another.

ALYN’s lecture hall was full to the gills, and the 50 members of the audience had a fascinating lecture. The participants were impressed by the sheer amount of knowledge the Ethiopian elders had, and how much knowledge Israeli society missed out on. Participants were enthusiastic to invite Yuvi back, to help them better understand how this knowledge can help the therapeutic process.

Many thanks to Yuvi, to ALYN, and of course, to the Jerusalem Foundation for its ongoing support of cultural competency since its inception!

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In Your Language – Hadassah Celebrates a Decade of Cultural Competency

One of our first projects when we started the Cultural Competency project a decade ago, together with the Jerusalem Foundation, was to work with Hadassah in making its systems culturally competent.

Cultural Competency workshops in action

Cultural Competency workshops in action

A large component of their work was establishing a translation service for patients. This grew into the “In Your Language” project, which today provides in-person translation and interpretation from Hebrew into Arabic, Russian and Amharic, in both of Hadassah’s campuses, Mount Scopus and Ein Kerem. Here is the clip from 2011 about the project:

Recently, the Israeli Foreign Ministry recently made a short video in Arabic for its Arabic Facebook page. We just had to share this! Here’s the video:

 

Many thanks to the Jerusalem Foundation for its continued support of our cultural competency program since its establishment.

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Celebrating a Decade of Cultural Competence – Third Lecture in a Series

We’ve reported here about Cultural Competency’s 10th anniversary year, which we’re celebrating with a series of lectures at the ALYN Rehabilitative Hospital. On Monday, June 25 we heard the third lecture, by Mr. Kassim Baddarni, Director of the El-Taj organization that advocates for Muslim patients.

The Muslim Patient

Mr. Kassim Baddarni, The Muslim Patient

In his lecture entitled, “Care for the Muslim Patient – between Competence and Apathy.” He spoke about cultural, linguistic and religious principles that affect care for Muslim patients, and what they require for the most effective care. He also spoke about what is permitted and forbidden in medical care according to Islam. These can be divided into 4 principles:

  1. The need cancels out the prohibition. Thus, for example, it’s permissible to get insulin shots or take medication that contains alcohol (which is usually forbidden in Islam), since these treatments are irreplaceable.
  2. Abstention from anything that harms the body physically or emotionally, such as smoking or any other risk factor.
  3. When faced with a situation that presents two acts that are generally forbidden under Islam, one should choose the act that does less harm, such as an abortion that aims to save the mother’s life.
  4. The public good comes before personal benefit. Thus, giving blood and donating organs are allowed and encouraged.

Many thanks to ALYN for being the trailblazers of Cultural Competency a decade ago, and for the use of their space this year. And of course many thanks to the Jerusalem Foundation for their strategic partnership in Cultural Competency since the conception of the program.

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Celebrating a Decade of Cultural Competence

It’s really been 10 years, a decade since we began our Cultural Competency project in the health system. In March 2008 we held what turned out to be the first conference on  Cultural Competency at the ALYN Rehabilitative Hospital. In the 10 years since, we, and ALYN, have been trailblazers in cultural competency in Israel. ALYN was the first hospital to strive for full cultural competence on an everyday level, and we have become national leaders in cultural competency not only in the health care system, but in a range of different areas – from the work place to welfare and other municipal departments.

Dr. Maurit Be'ere and Daud Alian, addressing the first lecture celebrating a decade of Cultural Competency

Dr. Maurit Be’ere and Daud Alian, addressing the first lecture celebrating a decade of Cultural Competency

We decided to celebrate this accomplishment with a series of lectures on Cultural  Competency. The first focused on a lecture by Daud Alian, Director of the Atta’a Assistance Center for the Rights of Palestinian East Jerusalem Residents, on accessibility of Palestinian residents of East Jerusalem to health, welfare and education services.

The audience, listening attentively

The audience, listening attentively

ALYN’s lecture hall was full. Dr. Adit Dayan, Director of Community Projects from the Jerusalem Foundation, our strategic partner in Cultural Competency since its inception, opened the conference, along with Dr. Maurit Be’ere, Director of ALYN and the person responsible for bring cultural competency to the hospital, and Tal Cohen, who today is the coordinator for cultural competence at ALYN.

We can’t thank the Jerusalem Foundation enough for their partnership over the years.

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Cultural Competency Coordinators – Putting Themselves in the ‘Other’s Shoes

One of the best ways to reduce inter-cultural tensions is by mentalization – understanding everyone’s viewpoints, needs and wants. Acknowledging the complexity of the situation, and even going through the process, helps to ease tensions, explained Irit Hovitz Fleishman, MSW, Founder and CEO of Grand Staff, which helps organizations and businesses manage greatly diverse staffs. Irit was the guest lecturer at the quarterly meeting of Jerusalem-based Cultural Competency Coordinators that took place on March 7, 2018, at the JICC.

Learning new tools for cultural competency with Irit Hovitz Fleishman

Learning new tools for cultural competency with Irit Hovitz Fleishman

There were representatives from ALYN, Hadassah (Mount Scopus and Ein Kerem), Sha’are Zedek hospitals; the Jerusalem Center for Mental Health; Leumit and Meuchedet HMO’s; and even the newly-appointed Cultural Competency coordinator for the Yehuda Abarbanel Mental Health Center in Tel Aviv. Each representative was asked to bring a few case studies that required cultural sensitivity. The encounter was dedicated to learning Irit’s unique method of multi-cultural management, as well as learning practical methods by examining the case studies.

Examples included:

  • Maintaining volunteers from many cultures
  • Sensitivities to status and the boundaries of different positions
  • Cultural adaptations of staff events and holiday-time presents
  • Dealing effectively with political tensions resulting from outside events
  • Managing staff meetings, dietary restrictions (Kashrut, Halal), fasts, holidays (and vacation time)

Many thanks to the Jerusalem Foundation, which has been a strategic partner in Cultural Competency since its inception.

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Cultural Competency Weaved into the Fabric of Sha’are Zedek Medical Center

A woman comes to the hospital to deliver a baby, and her husband is the one who speaks to the doctors. How do you best communicate? How do you make sure that the woman’s needs are being met, while respecting the cultural mores of the patient, which dictate that the man does the talking?

This is just one of the examples discussed last week in a cultural competency training seminar that was held at Sha’are Zedek Medical Center last week, for 15 staff members from the gynecology clinic.

Staff training staff at Shaare Zedek

Staff training staff at Shaare Zedek

But this seminar was different than other seminars. This one was led by Sha’are Zedek staff, in a regularly-scheduled staff meeting.

We reported here and here about our two Training the Trainer courses, which sought to enable in-house staff at the different health services in Jerusalem to present the principles of cultural competency / sensitivity to other staff members. In discussions with Sha’are Zedek, it was decided that short introductions, during regularly-scheduled meetings, would be the best way to ensure that as many staff as possible were introduced to the basic concepts of cultural competency.

The staff meet a wide range of ethnicities and cultures in their work in the outpatient clinics and delivery rooms. The seminar seeks to help them respond to the needs of patients and their families in a way that is culturally sensitive to all of Jerusalem’s diverse population groups.

In light of the response to this seminar, staff are already planning the next, this one to the reception staff of the general outpatient and eye clinics. Congratulations to Sha’are Zedek, for being one of the few hospitals that have made cultural competency training part of its business-as-usual in staff meetings.

Many thanks to the Jerusalem Foundation for its partnership in developing the cultural competency program since 2008!

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Cultural Competency team and Santé Israël at National Ministry of Health Conference

On December 4, Santé Israël and our Cultural Competency team participated in the annual Ministry of Health conference on “Inequality in Health Care.” This was an excellent opportunity to advance and provide information about the number of different areas we work in.

Learning from Wisdom of Experience

Learning from Wisdom of Experience

In preparation for this conference we collected and published all 7 Wisdom of Experience newsletters into a brochure. Today this includes:

We also distributed Santé Israël flyers, as well as information about our new workshops on health and Haredim.

JICC helping to close gaps in health care in Israel

JICC helping to close gaps in health care in Israel

Many thanks to the Jerusalem Foundation for their ongoing support of the Cultural Competency project since its inception. Many thanks to the Pharmadom and Rashi Foundations for their continued support of Santé Israël.

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Wisdom of Experience in Cultural Competency

After 10 years trailblazing the area of Cultural Competency we and our partners in action have garnered a broad spectrum of experience in a wide variety of areas. Throughout the country, there are many people who have developed expertise in different aspects of cultural competency, in different disciplines. They’ve dealt with countless difficulties and are proud of impressive achievements. We’ve all come a long way. After 10 years, we and our partners in action are excited to share some key aspects of Cultural Competency in Israel, and are taking a moment to reflect on the journey of the last decade.

We’ve called this reflection “Wisdom of Experience” newsletters. They detail different issues in Cultural Competency that we’ve dealt with. Each 3-5 page description includes a page introduction about the topic, plus a detailed description of the subject, written by our partners in the field.

Rabbi as a Hospital Consultant

Rabbi as a Hospital Consultant

Thus far we’ve written about (in Hebrew):

Rabbi as a Hospital Consultant (for matters concerning the Ultra-Orthodox population)

In Your Language – Language Accessibility at Hadassah Medical Centers

Assimilating Use of a Telephone Interpreting Hotline

Training at the Western Galilee Medical Center

We’ll continue publishing these newsletters monthly. Other subjects soon to be published include our Haifa-based round table with Haredim and the Maccabi HMO, Cultural Competency in Mental Health, making health services accessible to French-speaking olim, and more.

These newsletters join our series about multi-cultural and religious holidays, that we continue to revise in 2017 (on our Hebrew publications web page).

Many thanks to the Jerusalem Foundation for their continued partnership and support of cultural competency over the past decade!

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Continuing Support for Jerusalem Medical Interpreters at Shaare Zedek

It’s always nice to be praised by someone else. This time, it was by the Sha’are Zedek Medical Center’s social media team, after our Dr. Michal Schuster led a meeting for Jerusalem-based medical interpreters.

Dr. Michal Schuster, leading the workshop

Dr. Michal Schuster, leading the workshop

Here’s their Facebook post:

 

The meeting was held on July 19, for more than 20 medical interpreters. Most were from Sha’are Zedek, and others came from Hadassah Mt. Scopus and Ein Kerem hospitals, ALYN Rehabilitative Hospital, as well as from the Tene Briut organization. The first part of the meeting dealt with the role of medical interpreters in bridging cultural as well as linguistic gaps. In their training the medical interpreters had studied mainly how to translate medical terms from one language to another; the concept of bridging between cultures was not focused on. Michal raised several examples in which medical interpreters were faced with the need to bridge cultural gaps, and they discussed how to approach these differences. This discussion was important for the interpreters, since previously many had focused mainly on language translation, and the concept of cultural bridging, although an important intuitive aspect of medical interpretation, had not received as much attention. It was now brought front and center.

Afterward, participants split up into groups according to mother tongue. Each group discussed specific issues pertaining to medical interpretation in that language.

Thanks to Sha’are Zedek for the mention! And of course, many thanks to the Jerusalem Foundation for their continued partnership in our Cultural Competency efforts throughout the past decade and into the future!

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Cultural Competency in the Workplace: Health Care

We’ve mentioned here the many ways we develop cultural competency in the health care system – from the perspective of the national and local authorities (Ministry of Health, municipalities) to HMO’s, individual clinics and hospitals, schools of nursing and medicine, and more.

We continue to introduce  concepts of cultural competency wherever we can. This includes the Change Agents course of the Israeli Forum for Employment Diversity, which consists of businesses and non-profits that are working to further diversity in the workplace. This includes increasing the integration of populations with disabilities as well as a range of cultures and ethnicities.

Orna Shani, Desk Director, lecturing

Orna Shani, Desk Director, lecturing

We’ve been giving lectures to the Forum for some years now. Cultural Competency Desk Director Orna Shani recently lectured to a course for diversity managers from health care organizations, hospitals and HMO’s, from throughout the country. The main goal of these diversity managers is to integrate populations with special needs into the work force.

Of the 25 participants, only 5 had heard about cultural competency before. Our discussion included language accessibility, on the connection between diversity and employment, the current situation and the desired situation.

Many thanks to the Jerusalem Foundation for their continued support of cultural competency since its beginning.

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