Cultural Competence | The Jerusalem Intercultural Center

Continuing to Advance Cultural Competency in Jerusalem Health Care Systems

At the recent Jerusalem as a Culturally Competent City conference we called cultural competency for health care professionals, ‘advanced cultural competency.’ But it doesn’t matter if they’re advanced or just starting out. One of the main takeaways from the conference was that cultural competency is an ongoing process that needs to be constantly reviewed and re-visited.

So last week, on June 7, we continued the process for cultural competency coordinators from Jerusalem HMO’s and hospitals with a joint meeting and peer learning session. There were representatives from the ALYN Rehabilitative Hospital, Hadassah Mt. Scopus as well as Ein Kerem campuses, Sha’are Zedek, and Meuchedet, Maccabi and Leumit HMO’s.

Exercises in principles of cultural competency

The goal of the meeting was to discuss challenges the coordinators have in assimilating principles of cultural competency in the different health care institutions. Issues included:

Including doctors in the training;
Assimilating telephone interpreting into everyday use;
Coping with the loneliness of the position;
Lack of resources;
Strategies of dealing with workers who refuse to show cultural sensitivity;
Working on Shabbat, and more.

Participants shared tips and suggestions from their experiences. In addition, Dr. Michal Schuster presented part of the recently-published research she conducted with Irit Elroy and Ido Elmakais regarding accessibility to signage in public and government hospitals. Michal was gave participants suggestions on how to better adapt signage and make it more accessible to different cultures.

Many of the participants said they felt the meeting was a great help and that they wished to continue to meet on a regular basis.

Many thanks to the Jerusalem Foundation for its continuing support of this program.

Naomi Roff2016-07-02T15:24:20+00:00June 18th, 2016|Asylum Seekers, Blog, Christians, Cultural Competence, Cultural Competence in Health Services, Ethiopian Jews, Identity Groups and Conflicts, Jewish Religious Denominations, New Immigrants, Palestinians/Arabs, Ultra-Orthodox Jews|

Training Students of Optometry in Cultural Competence

We’ve discussed how Hadassah Academic College is becoming the first academic institution to become culturally competent. We started with staff and administration, and now we’re moving on to training students.

Learning the cultural competence of optometry care

On June 1 we held our first workshops with 33 students of optometry who are in their fourth and last year of training. This group in and of itself was one of many cultures – Jews, Muslims Christians, religious and secular, new immigrants and veterans.

The workshop was adapted from our one-day introductory workshop. Students learned how to provide culturally competent services, as they drew upon their own experiences at the college.

“It was weird for me to call the lecturer by his first name. In my school we never call the teacher by his name, we called him ‘teacher,'” said one participant.

They had studied together for years and knew one another, but had never discussed issues relating to their identities, and to cultural competency. “This was the first time I’ve had an opportunity to get to know Christians,” said another participant.

They also learned different skills that are unique to Jerusalem – how to give an Ultra-Orthodox person (who is forbidden to touch someone of the opposite sex) a vision test. Or what happens if there isn’t a common language.

A Christian student shared that once, in preparing for an eye test, a client asked her to hide the cross that was on her necklace. The discussion that ensued touched on a number of subjects – on generalizations, legitimacy of the request, the public space, and social and political tensions. At first the student was hesitant about sharing the experience, but afterward she was appreciative of the support.

Next year we are planning workshops for students in all 4 years of their optometry study, each year deepening their understanding of cultural competency.

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

Naomi Roff2016-06-12T13:19:48+00:00June 8th, 2016|Blog, Cultural Competence, Cultural Competence in Academic Institutions, Identity Groups and Conflicts|

“Jerusalem as a Culturally Competent City” Conference

In what other setting could you find the Jewish Mayor of Jerusalem introduced in both Hebrew and Arabic, followed by the President of the Jerusalem Foundation, herself addressing the audience in English, Hebrew and Arabic, followed by a Muslim Canadian keynote speaker of Pakistani origin? Only at the “Jerusalem as a Culturally Competent City” conference, which we hosted, along with the Jerusalem Foundation, at the Jerusalem Cinematheque on Tuesday, May 17.

It was the culmination of 10 years of working to advance cultural competency, together with the Jerusalem Foundation. What began as focusing on health care, at the ALYN Rehabilitative Hospital, at Clalit primary care clinics and at the Hadassah Medical Center Mount Scopus has blossomed into a concept that encompasses all fields and all sectors, in Jerusalem and throughout Israel.

Opening the conference in Arabic and Hebrew

Throughout the day over 300 people participated, listening to over 70 speakers. They came from all walks of life, from all different fields. We had professionals from the municipality, senior officials in planning, education, welfare and community life. We had researchers and leaders from colleges, universities and think tanks. We had active community residents. We had professionals from a wide range of NGO’s. We had the Israel Police and the IDF. We had Christian and Muslim Arabs, some residents of East Jerusalem, some not. We had secular, traditional, religious and ultra-Orthodox Jews. The entire day was conducted with Arabic, Hebrew and English on equal footing. (You can see the tri-lingual program here.) We had it all. We had Jerusalem in all its wonderful diversity.

The tri-lingual invitation

Throughout the day, we discussed ways that service providers, in all fields, can make their services equally accessible to all of Jerusalem’s populations, making them culturally competent. And on the residents’ side, we discussed ways that they can work to improve their own access to these rights and services, many of which are guaranteed them by law. We discussed strategies and challenges, and the process in between. It was fascinating, exhilarating and downright riveting.

Ms. Uzma Shakir, Keynote Speaker

Mayor Nir Barkat opened the conference, saying: “The starting point for any activity that we do in Jerusalem is the city’s unique DNA, which is unlike any other city in the world.” When the city was founded, more than 3,000 years ago, “its gates were open to everyone, all tribes, Jewish and not…No one felt like they were a guest in Jerusalem…Everyone found their place,” he continued. It is this philosophy, where everyone finds their place, that informs us to this day.

Jerusalem Mayor Nir Barkat at conference

Yohanna Arbib-Perugia, President of the Jerusalem Foundation, was the next speaker. She emphasized the important role of cultural competence in a diverse and unique city as Jerusalem. Seeing the Jerusalem Intercultural Center as a strategic partner of the Foundation, she believes that the focus of the Foundation on cultural competence will deepen in the coming years.

Uzma Shakir, Director of the Office of Equity, Diversity and Human Rights, City of Toronto, was the keynote speaker. She described the processes taking place in Toronto and throughout Canada regarding multiculturalism and cultural competency, which include developing approaches appropriate to the vastly different population groups in Canada, from the native populations to the Francophone community of Quebec to recent immigrants from south Asia and elsewhere. She first defined the role of cultural competency:

Cultural competency can be viewed in two ways: it can either be seen as paternalistic and prescriptive – something you do for others who have either limited or unequal power to claim their rights; or transformative and critical – consciously producing spaces that address those power differentials in a meaningful manner and eventually lead to an equitable and just society. In other words, cultural competency can mean being nice to people while maintaining the status quo of inequality or it can mean empowering marginalized people to take control over their own destiny and to change the conditions in society to produce equitable and just outcomes for all. However, this requires an honest recognition of who is marginalized and then consciously co-creating the conditions for inclusion. In this sense, Toronto has its challenges just like Jerusalem and provides some compelling lessons.

She explained the desired outcome of culturally competent processes through this picture:

Three views of Equity

In the first approach, existing infrastructures render services equally for different people. However, since people’s needs are different, equal provision of services does not create proper equality. In the second approach, adjustments are made, often ad hoc, to be able to work within the existing infrastructure to provide services in a way that responds differently to the different needs. In the third approach, infrastructure is built from the start with the different needs of different people in mind, to enable each to meet his or her particular needs in the best way possible.

Here is Ms. Shakir’s full speech:

For the speech in written form, click here.

Discussing challenges to cultural competency

Following the opening session, four parallel sessions addressed different aspects of cultural competency. These included, “Setting & Implementing Cultural Competence Policy in An Organization,” “Cultural Competence in the Public Sphere,” “Coping with Social and Political Tensions in a Multicultural City,” and “Cultural Competence Activities of the Community.” Speakers included the directors of the Bloomfield Science Museum Jerusalem, Museum of Islamic Art, the Tisch Family Zoological Gardens, the ALYN Hospital Pediatric Rehabilitation Center, the Haredi College, community centers from around the city, senior officials in the Municipality, and many, many more.

Setting and implementing cultural competence in organizations

Setting and implementing cultural competence policy in organizations

Even lunch was an exercise in cultural competency. Different foods were labeled with no translation in a range of languages – from Amharic to Russian to Polish and more. Choosing food at the buffet became a funny challenge….

How do you say salmon in Amharic?

After lunch the plenary session discussed major organizations’ efforts to make their services culturally competent. Speakers ranged from the Director of Community Services Administration in the Jerusalem Municipality, the President of Hadassah Academic College, the Director of the Jerusalem Center for Mental Health, and the Commander of the David Precinct of the Israel Police (which includes the all resident quarters of the Old City (Christian Quarter, Muslim Quarter, Armenian Quarter, Jewish Quarter), plus sites such as the Western Wall, the Temple Mount / Haram al-Sharif, Mount Zion and the David’s Tomb complex). The final parallel sessions discussed case studies in cultural competency in different fields – education, health care (This was considered ‘advanced cultural competency’ since indeed our work began in health care some 10 years ago.), arts and culture and community activism toward tolerance.

Our heartfelt thanks go to the Jerusalem Foundation for their partnership and support over these past 10 years. And many congratulations on their 50th anniversary celebrations, of which this conference was a part.

It was the first conference surveying cultural competency in Jerusalem. Will there be another? Stay tuned to find out.

Looking for more? Here’s the video of the entire opening session:

Naomi Roff2017-05-02T07:31:16+00:00June 1st, 2016|Asylum Seekers, Blog, Christians, Cultural Competence, Cultural Competence in Academic Institutions, Cultural Competence in Health Services, Cultural Competence in the Workplace, Ethiopian Jews, Identity Groups and Conflicts, Jewish Religious Denominations, New Immigrants, Palestinians/Arabs, Santé Israël - French internet platform on the Israeli healthcare system, Ultra-Orthodox Jews|

Awareness-Raising Meeting for “Santé Israël” – Increasing French Speakers’ Accessibility to Healthcare

“Santé Israël” began as a web site, translating the Israeli healthcare system into French and making it accessible to French speakers in Israel. But equally important as the information is the community that uses it.

Discussing health under the stars

Since its launch in September 2015, “Santé Israël” has striven to build a community around the web site, with a Facebook page as well as community meetings. On Sunday, May 22, they took the meeting outside, at the Baka’a Community Center.

The meeting targeted at French speakers from all over Jerusalem and it was organized by the JICC, the Jerusalem Municipality – Municipal Absorption Authority and the Immigrant Coordinator of the Baka’a Community Center. Over 30 residents enjoyed the evening, which took place under the stars in the Community Center’s courtyard. The audience heard a lecture by endocrinologist Dr. Asher Corcos from the Clalit Health Services, who spoke about diabetes and how to prevent it. Our own Marie Avigad, Director of the Santé Israël Program, introduced the web site and showed the audience the different aspects of it.

More meetings in different neighborhoods are planned.

Here’s the Facebook post (in French):

Many thanks to the Fondation Pharmadom for their continued support of this program.

Naomi Roff2016-06-12T12:49:00+00:00May 31st, 2016|Blog, Cultural Competence, Cultural Competence in Health Services, Identity Groups and Conflicts, New Immigrants, Santé Israël - French internet platform on the Israeli healthcare system|

First Time Ever! Training for Cultural Competence at a Hospital Chain

As we’ve developed our programs in cultural competence over the years, one of our goals has been to reach a point of being able to build capacity within each organization, so that cultural competence becomes an inherent part of their DNA.

Thus, a few days ago, for the first time ever, we began working with a chain of hospitals and health clinics. On April 11, we began working with the Assuta Medical Center, a network of four hospitals and six medical centers throughout Israel, in the first of three workshops.

First workshop with Assuta

This workshop included 60 facilitators, from all disciplines at Assuta, who will lead cultural competency workshops for all Assuta employees. It is taking place in Assuta’s School of Professionalism, which opened two years ago. After the training these facilitators will hold cultural competency workshops for all of Assuta’s 2,800 employees in the upcoming 6 months.

Congratulations Assuta! We’ll keep you posted on the additional workshops.

Naomi Roff2016-06-12T11:03:41+00:00April 16th, 2016|Blog, Cultural Competence, Cultural Competence in Health Services, Identity Groups and Conflicts|

Atta’a – Helping Palestinian Residents of East Jerusalem Obtain their Rights

‘Awareness is the first step toward change,’ is the adage that guides Atta’a, the Center for Rights Realization for Palestinian residents of East Jerusalem. Atta’a was founded in 2005, and recently came under our aegis. There is much work to be done, and we’re excited to build on the hard work and network that have been put into establishing the rights center.

Over the past few months Atta’a has been busy building its infrastructure. First there was the web site (in Arabic):

Attaa screen shot

The Facebook Page (also in Arabic) has grown to more than 1,400 likes in the past four months alone:

A few weeks ago we told you here about the brochure that they published. And more are on the way.

Cover of rights booklet

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

Naomi Roff2016-05-13T14:19:33+00:00April 12th, 2016|Attaa, Blog, Cultural Competence, Effective Activism, Identity Groups and Conflicts, Palestinians/Arabs|

Santé Israël – Creating Both Real-life and Virtual Community

Santé Israël isn’t just a web site – albeit an incredibly rich, information-laden web site – anymore. It is also creating real-life community. We’ve already rolled out the web site and Facebook page, and the next step is to create a real-life community surrounding the virtual one for French-speaking immigrants – one that will better enable access to Israel’s health care system and improve the community’s health care.

Since the beginning of March we’ve been bringing the electronic information to the people. We began in Bayit Vegan. Sante’s coordinator, Marie Avigad, introduced the web site to a group of 15 – 20 women. The women were very enthusiastic and interested in the web site, for themselves as well as for friends and relatives here, as well as those in France. They asked about different aspects relating to Israeli health care – prescriptions, referrals, hospital and outpatient coverage, payment for ambulance, emergency medicine hubs, medical interpretation, what the site tells about the different HMO’s.

Sante in Har Homa

The hit of the evening – an information sheet about how to prepare for a trip to the doctor, as well as the link to the WAZE social GPS app that is embedded in the site. Thus, a patient can be guided to the nearest clinic / hospital via WAZE, via the site. At the end of the evening, the women asked how to put a shortcut to the site on their cellphone screens so they always have it handy.

Our next stop was Har Homa. There, the evening included not only an introduction to Sante Israel, but also a lecture by nutritionist Yael Sayag-Shofen from the Maccabi HMO, who spoke about the myths of nutrition, or how to promote good health thanks to a truly balanced diet.

Yael Sayag-Shofen, nutritionist

This project has been made possible thanks to the Pharmadom Foundation, which works under the auspices of the Foundation of French Judaism (FSJU) and the Rashi Foundation.

Naomi Roff2018-06-04T04:48:50+00:00March 18th, 2016|Blog, Cultural Competence, Cultural Competence in Health Services, Identity Groups and Conflicts, Jewish Religious Denominations, New Immigrants, Santé Israël - French internet platform on the Israeli healthcare system|

Petition! Santé Israël Website – Example of Helping French-Speakers in Israel in Healthcare

“For years, the Pharmadom Foundation has helped the most vulnerable populations in Israel to seek and support emerging or not covered by government requirements. This is what led us to recently create the Santé Israël (“Health Israel”) website, which has quickly established itself as a valuable tool to help French Olim to navigate the Israeli health system.”

This is what the Pharmadom Foundation said about our Santé Israël website in a recent petition that seeks to enable French-trained pharmacists to practice in Israel without being required to take certification examinations.

Pharmadom petition site

Santé Israël was launched in September 2015, and was developed thanks to a partnership with Pharmadom. Santé Israël is a mobile-friendly website makes Israel’s health care system accessible to French speakers. The site offers comprehensive explanations about Israel’s health care system, which is vastly different from that of France, as well as its four main health funds.

We’re happy to be a prime example of their work. Many wishes for success with the petition!

Many thanks to the Pharmadom Foundation for their ongoing support of the project. The Pharmadom Foundation works under the auspices of the Foundation of French Judaism (FSJU) and the Rashi Foundation.

Naomi Roff2018-06-04T04:48:50+00:00February 18th, 2016|Blog, Cultural Competence, Cultural Competence in Health Services, Cultural Competence in the Workplace, Employment, Identity Groups and Conflicts, New Immigrants, Santé Israël - French internet platform on the Israeli healthcare system|

Healthcare Certification Training: Taking Stock

Over the past few weeks we’ve gotten some great news – that 6 more occupational therapists who took our course passed the Ministry of Health certification exam, and several more were very close. As the results continue to come in, we thought we’d take stock over the past 4 years of the program. We’ve really come a long way:

The program has increased the number of certified Arab paramedical professionals in East Jerusalem exponentially. Since it began in 2012, nearly 70 nurses, occupational therapists, and physical therapists to pass their Israeli certification exams. This includes 37 nurses, 24 occupational therapists and 6 physical therapists. Beforehand, only 1-2 would pass each year in each discipline. It would have taken many years to achieve these results otherwise.
The program has enabled us to more clearly map the situation of different paramedical professions in East Jerusalem, contributing to the knowledge of training in the Jerusalem area. As we developed courses for different disciplines, we have gained an in-depth knowledge of the state of diverse fields in East Jerusalem. This is the first time ever that any type of mapping has been done, and this information is now available for the first time to health care and educational institutions, as well as the Israel Ministry of Health.
The program has raised awareness both among Palestinian institutes of higher education and health care institutions in East Jerusalem as well as Israeli Ministry of Health. When we began the program, there was little compliance and even less awareness about the need and benefits of having staff that have passed the certification exam in their fields. Today, all the major health care institutions in East Jerusalem, Palestinian universities, as well as Ministry of Health, better understand this need. We believe this understanding will lead to an improvement in health care in East Jerusalem.
The program has opened a large window of opportunity for Arab women paramedical professionals to improve economic opportunities. After they pass their certification exams improves their access to employment rights, which includes an increase in pay and employment conditions.
As a result of the program, the JICC has earned a prestigious reputation for offering high-quality courses. Since we began these courses, graduates of the physical therapy and occupational therapy courses have had high rates of success in passing the certification examinations. As a result of this success, graduates, and even expectant graduates, of the different Palestinian universities have requested to register for courses well in advance.
Our reputation proceeds itself in expanding to new disciplines. As a result of the success of graduates of physical and occupational therapy, graduates of other paramedical professions – speech therapists and medical laboratory technicians – have requested we develop courses, which are now in various stages of development. Thus, we have expanded our offerings from two to six (also including physical therapy, speech therapy, medical laboratory technicians and medical Hebrew). We are also in regular contact with the medical faculty of Al-Quds University, ready to assist if needed.

A meeting of the nursing course

We’ve just started a new course for physical therapists, and are developing courses for speech therapists and medical lab technicians. We’ll keep you posted on further updates.

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

Naomi Roff2016-02-20T08:37:40+00:00February 15th, 2016|Blog, Cultural Competence, Cultural Competence in Health Services, Cultural Competence in the Workplace, Employment, Employment Accessibility, Identity Groups and Conflicts, Palestinians/Arabs, Supporting employment in East Jerusalem|

Cultural Competence at the National Insurance Institute in East Jerusalem

Would you believe that the East Jerusalem branch of the National Insurance Institute (NII) is becoming culturally competent? Yes, this is the same Israeli bureaucratic welfare institution that’s gotten a bad name for its being cumbersome and unwelcoming, especially for the city’s Arabic speakers. Being an Israeli institution in East Jerusalem these days, especially if people are looking to you for support, is also rather difficult.

This is where we salute the branch’s workers, especially the upper management, who recognized the complexity of this situation, and sought to better accommodate the public they serve. Several months ago we were approached by the director of the East Jerusalem branch to develop a system of cultural competency. This is the first cultural competency work that has been done in any NII branch throughout Israel.

East Jerusalem National Insurance Institute

Over the past year we’ve been meeting with and observing different staff members, adapting our training modules to the particular model of the NII. Last week (January 27) we had our first training session with the workers. Much of the session focused on social-political tensions in interactions with clients. Many of the workers were happy to have gained tools to enable them to do their jobs better.

This session was the first, and we’ll continue to follow up and mentor the management and workers. One of the subjects of future workshops will be ‘Linguistic Simplification,’ which means to simplify the often jargon-laden text of NII forms into simpler language that non-native speakers can understand. In fact, the West Jerusalem branch liked the idea too, and soon we’ll be giving a workshop on Linguistic Simplification for the West Jerusalem branch as well!

Stay tuned for further updates from the National Insurance Institute – Jerusalem.

Naomi Roff2016-11-25T13:54:09+00:00February 4th, 2016|Blog, Cultural Competence, Cultural Competence in Government Institutions, Identity Groups and Conflicts, Palestinians/Arabs|