Cultural Competence

System-wide Cultural Competency Training for Israel Police

It might just be our largest – and most wide-ranging – project in Cultural Competency to date. This September, we, together with Mosaica – The Center for Conflict Resolution by Agreement, were tasked – by the Police Force Education Unit, under directive from the Minister of Internal Security and the national Police Commissioner, (!) – with providing 200 cultural competency training  workshops in five out of the seven police regions throughout Israel. When finished, the project will reach most of the tens of thousands of police officers and commanders throughout the country. This process began at the beginning of September and will run through December.

Police in training course

Police in training course

The directive is a direct result of our ongoing work with the police force and its Education Unit, which began last year.  You can read about this previous work with the Israel Police Force, with both officers and trainees, at the National Police Academy and at different police stations, here and here. Indeed, the Israel police force realizes that having culturally competent and culturally sensitive officers can improve their professionalism and their ability to resolve incidents more quickly, more effectively, and hopefully, with less violence.

But this training marathon was on an entirely different scale. Our first step was to hold a 3-day ‘train the trainers’ workshop for the 30 professional facilitators, social workers, community mediators, and more. Their job has been to facilitate the training seminars in police stations throughout the country.

In our work we’ve found that there is already a massive amount of knowledge and awareness of cultural competence and sensitivity – both intuitive and learned – across the different layers, different branches and different locations of the police. One of the main goals of our work with the police is to utilize the knowledge and experience that already exists and teach it in a structured way so that it can become even more widespread, standard practice throughout the 35,000-strong police force.

Much of the 5-hour introductory training taught through case studies. Here is one, from northern Jerusalem:

During the Muslim month of Ramadan, border police noticed a marked increase in violent behavior by Palestinians going through the checkpoints. This was unusual, since Ramadan is a happy time, and even charged places such as a police checkpoint are usually affected (positively) by the month-long holiday. In response, officers from the border police held a meeting with local Muslim leaders, to try and get to the bottom of the problem. The leaders noted that this year, the border police were using police dogs as part of their routine checks, and that there was a special sensitivity to these dogs, especially since the people were hurrying to the Mosque. The border police stopped using the dogs, and the situation was much calmer at the checkpoints.

At other times, case studies are used to spark discussion:

A man of Ethiopian descent calls the police hotline, “Help! Someone left a sunny-side-up egg outside my door!” (This means he’s been threatened with murder.) What do you do? How do you respond?

An ultra-Orthodox woman calls the police hotline, complaining of domestic violence. The patrol that is closest includes a female officer, who is supposed to confront the ultra-Orthodox man. How should this be handled most effectively?

Each station focused on a particular population group, often one with which they have specific contact. Thus, for example, one station in the Jerusalem city center chose to focus on the Ultra-Orthodox Jewish population. Another, in northern Jerusalem, focused on the Palestinian population. (We’d worked with them before, and then they’d undergone a special workshop on the Ethiopian-Israeli population, since there is a large concentration there.) A station in Natanya focused on French-speakers.

Learning the principles of cultural competency

Learning the principles of cultural competency

In addition to the standard workshop content we also invited expert lecturers to provide a more in-depth understanding. For example, in Natanya the director of the Elem organization, himself a native French-speaker, was brought in to speak about the Francophone youth in the city, their approaches toward the police, and ideas of how to improve connections with the police in order to improve the public order.

We understand the challenge of integrating these principles into the everyday work of tens of thousands of police officers who face a myriad of complex situations every day. But we’re excited to be part of the process.

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On Our Way to Making the Entire Jerusalem Municipality Culturally Competent

If making Jerusalem a culturally competent city is to continue to be one of our main goals, then making the Municipality Culturally Competent is one of our major tasks. The task is huge – there are dozens of municipal departments and thousands – if not tens of thousands – of municipal workers.

Slowly but surely, we’re working our way through. In the summer we began in-depth processes with the Community Services Administration, one of the Municipality’s main arms. You can read more about it here.  We’ve also begun working with the Comptroller’s office.

Learning about Mt. Zion from a Window to Mt. Zion perspective

Learning about Mt. Zion from a Window to Mt. Zion perspective

Last week, on October 6, staff from the Comptroller’s office had an intensive learning experience in cultural competency, with Mount Zion as a case study. They first had a tour of Mount Zion by Merav, coordinator of our Window to Mount Zion project, with an emphasis on some of the many stories of cultural competence that the project has facilitated over the past year, from enabling Christian pilgrims to enter David’s Tomb for a short time during the Orthodox Christian Pentacost (in years past this has caused violent reactions by Jewish devotees), to sharing the Mount on the during the weekend when the Jewish holiday of Purim and the Catholic and Protestant celebration of Easter. (You can read more about the Window to Mount Zion project here and here, and about Purim / Easter here.)

After learning about the uniqueness of Mount Zion and the Window to Mount Zion project, we presented the Comptroller’s office staff with a general overview of the principles of cultural competency at our home on Mount Zion. This began the discussion on how to integrate these principles into the everyday work of the Comptroller’s office.

They told us how excited they were to see these areas in person. They’d dealt with a lot of issues on Mt. Zion, but had never had the introduction and explanations that we gave them. They were happy to get that different perspective.

We’ll keep you posted on future developments.

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Our Cultural Competency Training for Police Makes Walla! News Site

Did you hear about the time when the police came into an tempestuous situation involving Ethiopians/Haredim/Arabs, and they succeeded in calming the waters, without incident and without anyone getting hurt?

Not usually your top headline. However, that is what we, together with the Israel Police Force, are striving for. We’ve been working with the Police over the past year to instill principles of cultural competency into the everyday training. You can read about this work with both officers and trainees, at the National Police Academy and at different police stations, here and here.

Recently, this ongoing training was covered by Walla! news in Hebrew, a major Internet news site in Israel. Click here to for the link to the entire article and accompanying video in Hebrew.  Click here to view a PDF version of the article.

Walla article

Walla article

How will this training affect police officers’ responses to everyday incidents? David Shoshan, one of the officers in the training course, noted in the video above, that:

The training basically opened my eyes to the different populations we serve. That, when we’re called to an incident, I might need to act a little differently, try to respect the people’s particular customs. Our main goal is to try to ensure that the incident is over as quickly as possible, that it’s been dealt with in the most professional manner as possible, in the calmest way possible, so that we can do our jobs as best as possible.

Thanks David. Let’s hope the other tens of thousands of police officers throughout Israel were paying attention as well.

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Bon anniversaire, Santé Israël! Happy Birthday Santé Israël!

Bon anniversaire, Santé Israël!

Happy first birthday, Santé Israël!

Just one year ago on September 1, 2015, Sante Israel, www.sante.org.il, which we developed in partnership with the Pharmadom Foundation and the Rashi Foundation, and the first web site that makes Israel’s health care system accessible to French speakers, went live. The site is a treasure trove of information about all aspects of the Israeli health care system, and enables French speakers to more easily navigate the system.

The Sante Israel web site

The Sante Israel web site

Over the year some 10,000 people visited the site, most from Israel but also 2,000 from France. The most popular page on the site was and continues to be the database of French-speaking professionals and clinics in different fields in Israel. Other popular pages include contact numbers, the page that directs you to the nearest clinic or hospital via the Waze mobile app, the page that tells you what your favorite medication is called in Israel, and more. And if you had any questions that weren’t on the site, you can ask the Director of Santé Israël, Marie Avigad, and she answered every query very quickly.

This past year Santé Israël did not stay behind the screen, and went out into the community to continue to make Israel’s health care system more accessible to French speakers.

Discussing health under the stars

Discussing health under the stars in Baka’a

They held a number of community meetings throughout Jerusalem, in areas such as Bayit Vegan, Baka’a and Har Homa, which have sizable Francophone communities.

Sante in Har Homa

Sante in Har Homa

They developed a Facebook page, which provides updates on a variety of health-related issues, as well as news of the Santé Israël community. They spread the word about new Israeli inventions relating to health care:

New developments by the different HMO’s

As well as health warnings and updates from the Ministry of Health (such as recent salmonella warnings and other potential health hazards).

They participated in the Jerusalem as a Culturally Competent City Conference that was held in cooperation with the Jerusalem Foundation on May 17, 2016.

Sante Israel together with other health care organizations at the Cultural Competency conference

Sante Israel together with other health care organizations at the Cultural Competency conference

And they participated in the  “Olimpiada” Aliyah information fair for French-speaking new immigrants, which was held at Sacher Park in the middle of town and was organized by Qualita .

"The first site to respond in French to your questions about the Israeli health care system

“The first site to respond in French to your questions about the Israeli health care system”

In addition, Santé Israël just began a partnership with AMI Israel, which helps French-speaking Olim in Israel. And Santé Israël has its own page on the AMI Israel web site. Here’s the Facebook post from Santé Israël:

So Mazal Tov to Santé Israël! May you have many more happy birthdays.

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Atta’a – Helping Individuals, Helping Groups Obtain Health Care Rights

A Palestinian woman recently approached the Atta’a Assistance Center for the Rights of East Jerusalem Residents with a problem. She was divorced, and had a very sick child who had been given medication that cost 1,200 NIS per month. With assistance from Atta’a volunteers, she submitted a special form available from the Ministry of Health that asked for a special discount on the medication. Her request was approved – now she receives an 80% (!) discount on this child’s medication.

This story is just one of many that Atta’a’s 15 volunteers encounter on a regular basis in one of their three help centers that cover all Jerusalem: Wadi Joz, Sur Baher and their main center in Beit Hanina.

Atta'a drop-in center in action

Atta’a drop-in center in action

In addition to individual consultation, Atta’a also provides group workshops on realizing rights, in health care, vis-a-vis the National Insurance Institute, and vis-a-vis the Ministry of the Interior. For example, on July 25, Daud our Atta’a director presented a workshop on rights available from the National Insurance Institute at a conference on type 1 diabetes for residents from East Jerusalem, which was held in cooperation with Magen David Adom. Other workshops covered family re-unification processes, together with the welfare office in Shuafat.

In order to drive up participation they’ve distributed flyers throughout East Jerusalem, such as in the Old City, Wadi Joz, Issawiya, Sur Baher, Silwan, Abu Tor, Ras el-Amud, A-Tur and the Shuafat Refugee Camp. They have also distributed flyers in front of the offices of the National Insurance Institute and the Ministry of the Interior.

Atta'a flyer

Atta’a flyer

Soon we’ll have a new handbook out, on accessibility rights. Stay tuned!

Many thanks to the Jerusalem Foundation for their continued support of this program.

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Cultural Competency Training for Municipal Community Department

Cultural Competency – we’ve talked a lot about it, on the blog and on our website, but what is it really?

When we began that discussion some ten years ago, we focused on the health care context. Indeed, if health care services are not culturally competent and sensitive to the vast diversity of cultures in Jerusalem and throughout Israel, it really can be a life or death situation.

Cultural Competency at Hadassah Hospital

Cultural Competency at Hadassah Hospital

But Cultural Competency is so much more than that. In those past ten years, we’ve developed and refined our definition of  Cultural Competency to encompass much of our entire approach to community work: All residents have the right to receive basic services (health, education, welfare) that are culturally adapted to best suit their needs. Cultural Competent services enable professionals to provide those services most effectively, and culturally competent residents are empowered to most effectively access these rights and services. You can read about the most recent work we’ve done to advance cultural competency in a number of fields – in health, the police, the workplace, academia. Now, we’re proud to be officially providing widespread training in the Jerusalem Municipality.

Training senior municipal professionals

Training senior municipal professionals

We’ve been working with the municipal welfare department for several years, facilitating workshops for them here and there, providing critical assistance in emergency situations (like the Haredi mother who was accused of starving her child). All the while, we were looking for ways to introduce cultural competency in a systemic way.

A few weeks ago it began. Not only the welfare department, with which we’d been working before, but the entire Social Services Department, which includes the Welfare Department, the Employment Authority, the Absorption Authority and the Public Health. About 80 senior officials from all the different Departments are participating in the first five workshops, which we are now taking place. The workshops introduce principles of the tools and insights of cultural competency.  But this is only the beginning. In the future we expect to hold workshops adapted to the different areas – veterinary services, well-baby clinics, absorption authority, daycare frameworks, welfare workers and social workers, and more.  All will undergo workshops led by those trained to lead cultural competency workshops.

Many thanks to the Jerusalem Foundation for its continued support of the Cultural Competency program throughout the years.

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“What do you say when…..” – Keeping Medical Standards High with Medical Interpreters

As a genetic counselor, what do you say when a family is struggling with infertility, or their unborn fetus has been diagnosed with a genetically-transmitted disease? How do you broach these subjects with Arab patients, or Haredi patients, or patients from different countries, where it is not acceptable to talk in public about issues relating to the child-bearing process? And how does the medical interpreter, who himself often comes from that community but is not trained in the discipline, deal with these questions?

Medical interpreting for genetic counseling was the subject of a recent workshop we facilitated for 18 Jerusalem-based medical interpreters from Hadassah (Ein Kerem and Mount Scopus) and Sha’are Zedek (main hospital and Bikor Holim, which is now part of Sha’are Zedek) – Russian, Amharic, Yiddish and Arabic-speakers in addition to Hebrew. We’re proud to have been a major part of the training and assimilation process of medical interpreters in Jerusalem, which the hospitals now consider an integral part of their care. (We’ve written here and here about these trainings in the past.) Like other aspects of professional healthcare, it is important for medical interpreters to maintain their skills through periodic professional development, and this workshop was part of an ongoing process of supervision and mentoring of the medical interpreters.

Discussing experiences in medical interpreting

Discussing experiences in medical interpreting

We chose to concentrate on genetic counseling because of its multi-layered complexity. According to the US-based Centers for Disease Control and Prevention, in genetic counseling, “specially-trained professionals help people learn about genetic conditions, find out their chances of being affected by or having a child or other family member with a genetic condition, and make informed decisions about testing and treatment.”  Because it brings together many different scientific disciplines, it is very difficult to understand, even for someone who studied advanced science. In addition, meetings with genetic counselors are stressful from the get-go, since one is consulted only when there is a problem (or a potential problem) in the child-bearing process – either before conception, during pregnancy, or after the birth of a child with genetic problems. Add to this the different approaches and viewpoints that different cultures have to the different stages of the child-bearing process, as well as their outlook on children with special needs – and the meeting with the genetic counselor is even more tension.

And when the medical interpreter is tasked with being the agent of communication during such a stress-filled meeting, it can be one of the more challenging of situations. Medical interpreters are trained to translate for all types of medical issues from cardiology to orthopedics to oncology, and are not trained as genetic counselors themselves. Sometimes, they feel uneasy with the subject matter, since it often breaches sensitive issues such as birth defects, sex, ending of a pregnancy, and sometimes their initial reaction is to skip over probing questions. At the same time, these questions are vital to the genetic counseling process, and it is critical that an experienced interpreter translate everything.

In the meeting we approached the subject from a number of different angles. After an opening exercise that focused on professional dilemmas in interpretation, participants heard a lecture from Shachar, a genetic consultant from Sha’are Zedek. They learned about the field of genetic counseling, for whom it’s targeted, the challenges in meeting with patients and the challenges in interpreting for patients. The genetic counseling process seeks to understand and evaluate medical and psychological information as well as family complexities related to genetic diseases. In addition to understanding the situation, genetic counselors also try to understand the different options appropriate for each patient and their families. This is why interpersonal communication, and interpreting into the patients’ native language, is of utmost importance.

After the lecture the interpreters discussed a number of challenges they’ve faced. In one example, a patient, who didn’t have the patience to hear what the genetic counselor was saying, told the interpreter, “Just tell her [the genetic counselor] whatever you want.”  Such an answer is sometimes difficult to translate, and makes the interpreter feel uncomfortable, but from the standpoint of the genetic counselor it is actually important information in the communication process between them. In this case, the interpreter must overcome his or her discomfort and translate exactly what was said.

They also discussed mediating and advocacy in medical interpretation – two terms that mean a deeper involvement of the interpreter in the meeting. They discussed situations in which these unusual cases might take place, and especially how to do it correctly.

In the end, they broke up into groups according to non-Hebrew language, and different lecturers taught terms specific to genetic counseling, pregnancy and birth in Arabic, Russian, Amharic, and Yiddish.

We hope to have additional peer learning sessions for medical interpreters in Jerusalem – they deserve it! We’ll keep you posted here!

Many thanks to the Jerusalem Foundation for its continued support of cultural competency in health care in Jerusalem.

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JICC Completes Training Course for Police Commanders

What is it like to be a police officer, and be responsible for keeping order and enforcing the law?

Police officers everywhere are on the front lines of law enforcement, bringing them into contact with a vast diversity of people. All too often, as we’ve recently seen in the USA as well as in Israel, events can get out of hand very quickly.

The Israel Police understands the complexities of working with Israel’s different – and sometimes conflicting – population groups, and for the past year we at the JICC have been working with various ranks and groups in cultural competency training.

Last week we finished a course for police officials at the National Police Academy. The 50 course graduates, Superintendents and Chief Superintendents, represent the next generation of commanding officers in the Israel Police. Each will command soon a police station or a large police unit. The JICC has been mentoring the course for the past six months, from introducing them to the concept, to integrating cultural competency into different areas of the training course, and in writing a module in the unit commander’s file – on how to operate a culturally competent unit. We, together with the course participants, edited the comprehensive file. In the summary meeting of the course that was held with the Police Commissioner Roni Alsheikh, the entire course’s work was presented. This included recommendations and tools on how to manage and operate a culturally competent police unit. The JICC, together with the officers of the course and the staff of the National Police Academy, will continue to work to advance the use of these recommendations within the Israel Police.

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End of Cultural Competency Training the Trainers Course at Assuta Hospitals

We’re writing here to report about the end of a series, but it’s actually just the beginning of a process.

When I talk about cultural competency I feel....

When I talk about cultural competency I feel….

We wrote here about the beginning of Training the Trainer workshops on Cultural Competency at the Assuta Medical Center Hospital and Medical Center system for 60 professionals from their School of Professionalism (They have been chosen as outstanding in their respective fields). This is the first time ever that an entire chain of health care centers has undergone such a process.

Assuta Medical Center

Assuta Medical Center

We met with these professionals for three full days (the last was last week), in which they received tools, knowledge and insights into how to facilitate cultural competency workshops. Since the beginning of June they have been leading the workshops. In October, they will present cultural cultural competency workshops to all of Assuta’s 2,800 employees.

Facilitating the workshop

Facilitating the workshop

The workshops included peer learning according to different cases. One participant told of a critically ill patient from a religious family. It was clear that the patient’s days were numbered. The family emphatically insisted on hooking him up to a sophisticated machine that was very noisy, expensive to operate, and did not help him medically in any way. Only when the medical staff asked why they insisted on this specific machine, they explained that it was important for them to know exactly when the patient died, so they knew when his soul left his body and they could say the Shema Yisrael prayer. Upon hearing this, and understanding that it was part of the family’s mourning process, they found other solutions. In the end, it was found that a simple, quiet blood pressure monitor would suffice for the family. Thus, the family was able to mourn in the way it needed to, without being an unnecessary burden on hospital resources.

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Santé Israël at the Olimpiada Aliya Fair for French Speaking Olim

One of the first things you do as an Oleh Hadash, or new immigrant to Israel, is become a member of one of Israel’s 4 national Kupot Holim, or HMOs. And so begins our saga with the Israeli health system.

At the Sante Israel table

At the Sante Israel table

If you’re lucky, and you’re a French-speaker, you now have the Santé Israël web site, developed and operated by the JICC cultural competence team, and more specifically by our Marie Avigad. Santé Israël describes the ins and outs of the health care system in Israel, which is quite different than that of France and other French-speaking countries.

"The first site to respond in French to your questions about the Israeli health care system

“The first site to respond in French to your questions about the Israeli health care system.”

Last Thursday, Marie represented the Santé Israël website and online community (here’s a link to its Facebook page as well) at the “Olimpiada” Aliyah information fair for French-speaking new immigrants, which was held at Sacher Park in the middle of town and was organized by Qualita . There were dozens of booths and tables offering services and information.

Many booths at the fair

Many booths at the fair

Marie’s table was especially busy, giving visitors a hands-on introduction to the web site.

Learning how to use the site

Learning how to use the site

In all 5,000 (!) people attended, and 35 organizations were part of the production of the Olimpiada, the first such gathering of Francophone immigrants since the establishment of Israel! Kol Hakavod to the Qualita organization for producing such an event. And of course, many thanks to the Pharmadom Foundation and the Rashi Foundation for their continuing support of Santé Israël.

Here’s the link to the Facebook post (in French):

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