Cultural Competence | The Jerusalem Intercultural Center

Continuing to Be at the Forefront of Cultural Competence Training: Now for the Immigration Authority vis a vis Asylum Seekers

There are some 50,000 asylum seekers in Israel who come from African countries, mainly from Eritrea and Sudan, and some 2,000 in Jerusalem. Currently, Israel’s policy toward this population is very harsh, with a stated goal of detaining as many men as possible and encouraging them to leave the country. On the surface, then, it would seem to be the last place to hold cultural competency training. And yet, hold that training we did. Together with the Center for International Migration and Integration (CIMI), we helped write a training handbook about Cultural Competency for those coming from Eritrea and Sudan in Israel (in Hebrew, here, and here is the link to the actual document). We also held a series of training workshops, the last of which was held on December 30, 2015.

We held workshops for all those who come in regular contact with asylum seekers. This included RSD workers (Refugee Status Determination) – those who decide if and when to grant refugee status; Enforcement – those who grant visas and evaluate the statuses; and those who expel asylum seekers from Israel. The workshop on December 30 was for department supervisors.

The training workshop was based on the basic introductory workshop to Cultural Competency that was developed for the health care industry, and adapted it to the needs of the immigration authority. It was not always easy. There were those who understood the need for cultural competency training – the great differences in language, religion, and culture between Eritrea and Israel – and the need to be sensitive to these differences. There was also sometimes a basic difference in understanding of terminology: Many of the NGO’s who work with asylum seekers speak of them as ‘asylum seekers’ who have rights that need to be obtained and services that must be delivered. However, the official terminology of the authorities is that of ‘infiltrators’ or ‘illegal migrant workers,’ which carries a whole different set of connotations. Despite this gap, CIMI, which works to help asylum seekers obtain their rights, has a strong working relationship with the authority. In addition, there are already a number of components of cultural competency at the facility where visas are checked – the announcement system and signs are translated into Tigrinya, asylum seekers are given special consideration during the month of Ramadan, and more.

CIMI Training handbook

The training handbook, written together with CIMI, was an important achievement. (Front cover pictured above.) This was the first time ever that such a comprehensive document was written and published. The handbook contains information about both Sudan and Eritrea, why they came, and cultural characteristics (concept of time, methods of communication, challenges in their community in Israel, and more). May this handbook serve the workers well.

In addition to workers from the immigration authority, we are working together with CIMI with a range of professionals – local police, municipal community and social workers in both Jerusalem and Tel Aviv, and more – to improve the cultural sensitivity of services to workers from Eritrea and Sudan.

Naomi Roff2016-02-01T17:33:18+00:00January 8th, 2016|Asylum Seekers, Blog, Cultural Competence, Identity Groups and Conflicts|

Training the Trainers in Cultural Competency – Reaching the Peak of Project Development

We’ve been working in Cultural Competency for a long time – 8 years to be exact. Our work has run the gamut of both deep and broad – our work at the ALYN Rehabilitative Hospital in Jerusalem included not only training all personnel in the principles of cultural competency, but also ensuring that signs and forms were translated into a number of languages, as well as enabling medical interpretation in a number of languages. Our work with the Israel Ministry of Health led to the directive that required all health care institutions to become culturally competent. We worked in individual clinics and HMO’s on the national level. We’ve been developing, together with the Bar Ilan University Department of Interpreting and Translation, training films and a training guide to use with the films. The guide was recently completed, which led us to the next natural step – a training the trainers course.

Training the Trainers Class Picture

The course was a 5-session workshop – 40 academic hours – that ran from November 5 – December 3, 2015. It included 15 participants from all over Israel, including 5 Jerusalem representatives – from ALYN, the Jerusalem Center for Mental Health, Hadassah Mount Scopus, Hadassah Ein Kerem and the Hebrew University of Jerusalem. Participants came from a wide variety of fields within the health care system – social work, occupational therapy, nursing, admissions officers, instructors in nursing schools and more. Two participants had already been our students – in medical interpreting courses for professionals in mental health fields.

The course was based on the short movies and the instruction handbook that were produced over the last two years. The course included skills on how to facilitate training workshops, cultural competency workshops that are based on the movies or on case studies that the participants bring with them. The course was such a success that we are already planning the next one – hurry and sign up, before it is full!

Naomi Roff2016-01-01T14:32:24+00:00December 13th, 2015|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, Ultra-Orthodox Jews|

Toward Culturally Competent Employment Training and Placement

Cultural competency affects us all, nearly everywhere – in the health care system, in the welfare system, in the education system, and more. Issues related to cultural competency also come into play in employment training and placement, and we are proud to be a part of change in the system.

Be-Atzmi workshop

On November 10 we held an all-day seminar for the Be-Atzmi organization, which assists thousands of unemployed and underprivileged men and women every year to integrate, on their own, into stable and appropriate workforce opportunities. Since Be-Atzmi often works with populations on the geographic and socio-economic periphery – including Israelis of Ethiopian descent, the Ultra-Orthodox, and Arab populations – a culturally competent approach to employment training and placement can be critically important for the program’s successes. Thus, this year the organization dedicated its annual professional development seminar to cultural competency.

More of the workshop

The seminar was held for all workers who come in contact with clients from throughout the country – some 150 people – and was held at the Academic College of Tel Aviv-Yafo. The day included teaching the different skills required to deal with different issues in a culturally competent manner. These included, for example, cultural objections to going out to work, refreshments during the Muslim month of Ramadan in mixed groups, integrating husbands into decisions, etc. The seminar dealt mainly with ‘personal cultural competence,’ which means how cultural competency affects individual people. For instance, a case worker suggested what seemed to be a perfect job for a Bedouin woman – working as a maid in a hotel. The pay was above minimum wage, the wages included full benefits, and the hotel provided transportation to and from work. The one problem – in Bedouin society, working as a hotel maid is not something ‘good girls’ do. It is considered to be ‘working in the bedroom,’ just one step up from prostitution (!) The solution – all the job seekers must be interviewed to see what kinds of jobs they’d be willing to take, and it must be made sure that cultural and religious norms are not infringed upon.

Participant in workshop

Other issues that were discussed were interviews, and the different ‘western codes’ of what is acceptable and not acceptable to say in an interview, being on time, involvement of the husband in decision-making – there is a gap between what the facilitators are used to and what the clients need.

As a result of the positive feedback received by organizers and participants, we will also begin to work with Be-Atzmi in developing their organizational cultural competence as well. This means ensuring that all forms and informative publications and signage be produced in a number of languages to fit the clients’ needs, that different culture’s holidays are respected, etc. In short, it means making sure that the broader picture that is the organization thinks in a culturally competent manner.

Naomi Roff2015-12-18T19:06:31+00:00November 17th, 2015|Asylum Seekers, Blog, Christians, Cultural Competence, Cultural Competence in the Workplace, Ethiopian Jews, Identity Groups and Conflicts, Jewish Religious Denominations, New Immigrants, Palestinians/Arabs, Ultra-Orthodox Jews|

Cultural Competency in Hadassah Academic College

The end of the Jewish High Holidays signal the beginning of the academic year for Israel’s colleges and universities. This year, Hadassah Academic College is beginning the year much more culturally competent than last, and it will continue the trend, into this upcoming school year.

Training at Hadassah College

We began working with the college in November of 2014, after a very difficult summer and fall in Jerusalem. During the year we began operating a series of seminars for administration and lecturers on the principles of cultural competency and how they applied to an academic setting. Read here for more information about the beginning of the process.

Practicing in big and small groups

The different types of course studies at the Hadassah College are are vastly different in nature from one another. There are those that are based on laboratory work, those that are based on frontal lectures, those that work with patients. Sometimes communication with the lecturers is direct and sometimes most of the students’ communication with the administration is done through counselors. So we adapted the different workshops to the different kinds of learning systems in place. In June and July, we held four full-day workshops for 80 faculty members from 7 different departments (laboratory sciences, environmental health, biotechnology, optometry and computer science), conducting workshops in groups according to learning style. Throughout the 2015 – 2016 school year we will continue to work with faculty from different departments. In the next stage, we will work with students who work with patients (such as speech therapy and optometry) during their training.

Naomi Roff2015-11-01T16:57:33+00:00October 25th, 2015|Asylum Seekers, Blog, Christians, Cultural Competence, Cultural Competence in Academic Institutions, Ethiopian Jews, Identity Groups and Conflicts, Jewish Religious Denominations, Jewish-Palestinian/Arab, New Immigrants, Palestinians/Arabs, Ultra-Orthodox Jews|

Launch of Groundbreaking Healthcare Web Site for the French-Speaking Community

À votre santé! Here’s to your health, in French.

We’re happy to announce the launching of www.sante.org.il, a groundbreaking web site that makes Israel’s health care system accessible to French speakers. The first of its kind in Israel, 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.

Sante homepage

The Israeli and French health systems are quite different and immigrants (olim) or future Olim are not always prepared. Until Sante Israel, much of the information provided by the authorities and health insurance companies were in Hebrew, English or Russian, and were scattered in various sources, making them inaccessible to large segments of the populations. Sante Israel has grouped them in a sensible manner, translated if necessary and presented them on one site.

The site includes information on medical institutions, medications available, services for different age groups (children, elderly …) and for different situations (pregnancy, chronic illness), payments and co-payments, what is covered and what is not in the various plans, etc. There are also many explanations on the differences between health care in Israel and that in France, such as emergency visits to the doctor, a glossary and explanations on important terms, guides to use existing information tools and links to useful sites. The site also provides a wealth of information for French-speaking health care professionals seeking to make Aliya to Israel, on equivalent degrees, equivalency exams, licensing, etc.

Navigate to nearest hospital through Sante

The site is also fully designed to be mobile-friendly. It is available on both Android and iOS smartphone systems, and has the ability to dial telephone numbers automatically by clicking on them. It also links directly to the Waze navigation app, which can direct the user to the closest hospital or medical center. It will also be linked to a Facebook page, an online chat, forums and an e-mail address, which will enable users to ask questions, receive advice, share experiences, and publish information, creating an active community with the site at the center.

We’d like to thank 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+00:00September 5th, 2015|Blog, Cultural Competence, Cultural Competence in Health Services, Identity Groups and Conflicts, New Immigrants, Santé Israël - French internet platform on the Israeli healthcare system|

Can Israel’s Police Force Become Culturally Competent?

The news is full of stories of the police’s treatment – appropriate or not – of civilians. Just recently Americans marked the one-year anniversary of the shooting of a young, black, unarmed man by a white police officer in Ferguson, Missouri, USA, which led to riots and civil unrest for some time. In May of this year Israeli police officer were shown beating a soldier of Ethiopian descent, which led to a wave of demonstrations of the Ethiopian community in Israel, and unrest in the streets.

Israel’s police force – and any police force – are under constant and almost unbearable pressure to keep law and order, working among a vastly diverse population. Educators in the Israeli Police Force recognized this complexity, and requested to begin working with us to develop a cultural competency training module for police cadets. To their credit, planning work actually began before relations between the police and the Ethiopian community made headlines. But the light shown on the police during the full-force demonstrations of the Ethiopian community this spring underlined the necessity of this kind of training. As a result, we began to working with all new police cadets, as part of their 14-week basic training course. At the same time, we are beginning an in-depth process with 23 police stations throughout the country.

At this first stage we are implementing introductory workshops to different training courses – basic policing, detectives, border police, cavalry, advanced policing – all are undergoing the basic 1 1/2 hour workshop. Since the beginning of June we’ve held 40 seminars, with 20 – 30 police cadets in each group. That’s already 1,200 cadets! After this, we will be organizing a Train the Trainers course for the regular instructors in the police academy, so the principles can be fully integrated into their training regimen.

The Israel Police Academy (credit: Israeli Police Facebook page)

More in-depth processes will be taking place in 26 police stations throughout the country that have high concentrations of Israelis of Ethiopian descent, including two in Jerusalem, Moriah in the south and Shufat in the north. In this process we are partnering together with the Gishurim project. The first step of this process will be a half-day seminar on cultural competency, using facilitators that we’ve trained. We will begin training the facilitators in September; they will then lead 150 seminars throughout the country.

And what do the police think about these training sessions? We’re finding that many, especially Jerusalemites, are already very in-tuned to the cultural complexities of our city, and make every effort to consider the effects that cultural sensitivity has on the residents with whom they come into contact. We are honored to be part of a process that seeks to bring law and order to all residents of the city.

Naomi Roff2017-05-02T07:52:10+00:00August 13th, 2015|Asylum Seekers, Blog, Christians, Cultural Competence, Cultural Competence in Police, Cultural Competence in the Workplace, Ethiopian Jews, Identity Groups and Conflicts, Jewish Religious Denominations, Jewish-Palestinian/Arab, New Immigrants, Palestinians/Arabs, Ultra-Orthodox Jews|

Building a Network of Services for Asylum Seekers in Jerusalem

We last described some of the efforts that we’re making to help African asylum seekers living in Jerusalem here . But in looking back since our first post on the subject in August 2013, we can be very, very proud. Not only can we report about achievements here and there, we can describe a whole network of services – from health care, to education, to employment, to social and welfare rights – that we have developed, together with a wide range of partners, from the Jerusalem Municipality, the Jerusalem Foundation, Jerusalem African Community Center (JACC), and many more. All work in tandem with the part-time coordinator we support, together with the municipality, to help to improve the quality of life of African asylum seekers in Jerusalem.As our Tal Kligman noted, “to have such a complete network of services after such a short time for a relatively small group of people, is nothing short of amazing. the community of African asylum seekers in Jerusalem has many needs and they are in a very difficult situation. But they are on the map, and there is a whole consortium of agencies and organizations that is looking out for them. We are proud to be part of this endeavor.” While the needs are very great, below are some examples of how far we’ve come.

Tour of Nahlaot neighborhood

Health Care. We’ve been working with the Meuchedet Health Services, which provides health care to most of the asylum seekers in Jerusalem. (Read here for an earlier blog post). This cooperation has continued, with vaccination drives for children, translation of forms to Tigrinya (the language spoken by asylum seekers from Eritrea, the most populous group), and ongoing work with the help of our Cultural Competency desk. There has also been joint work with the local well-baby clinic. We wrote here about the first aid evening for mothers that we held last year (including the black baby manikin that was used for CPR), followed by other first aid courses and workshops for parents. Workers and volunteers were on hand at the clinic on days they brought their children, to help them with language and other issues.

Education. We are part of an early childhood forum, which also includes the JEA, municipal welfare department, community representatives and other organizations, which seek to discuss the needs of the community and explore responses. We helped to translate school and kindergarten registration forms into Tigrinya, provided translation services during parent teacher conferences in the kindergartens. Together with the Jerusalem Education Authority (JEA), we held special registration days for public kindergartens with translators on hand, which included translating the registration forms, in the late afternoons and evenings, when the working parents were off work. These evenings were crazy (as in, not very orderly, but what can you expect with 3-4 year-old children running around in the evening?), but also very, very important. Until now, registration was either via the municipality’s web site (which is in Hebrew only), or physically, at the municipality building, which is also in Hebrew. Some children were registered and did attend municipal frameworks, but there were too many incidents where young children were left alone while their parents were at work. These included reports of a 4-year old child was seen wandering the streets unsupervised, or of a 3-year old girl who was babysitting for her younger siblings when her parents were at work. These children need to be in constructive frameworks.

Work with the children of asylum seekers doesn’t end with placing them in kindergartens. When there, many do not know Hebrew, which leads to behavioral problems and cognitive delays. In order to help the children, as well as the parents and the teachers, this past year the children were given didactic evaluations, thanks to the Jerusalem Foundation. The evaluations will enable the children to receive extra assistance, and help the teachers to integrate the children better into their classes.

Social Services. Programs included:

A parenting program operated by the municipal welfare department, targeting parents and children, aiming to strengthen parenting skills.
An information evening about workers’ rights, operated by the Lev Ha’Ir Community Council, together with the Worker’s Hotline organization and JACC.

In a community garden

Community. A number of initiatives aimed at integrating the community better into the general Jerusalem community. These programs are in cooperation with the Center for International Migration and Integration (CIMI) and the Lev Ha’Ir Community Council, which provides programming for all populations in the city center. Activities included:

Meetings between Israelis and asylum seekers
Story hour for Israelis as well as asylum seekers, featuring a story about about children of asylum seekers.
Hosting in neighborhood Sukkoth during the Sukkoth holiday.
Tour of the Nahlaot neighborhood, showing community members the different institutions, community gardens, and stories of the neighborhood. Participants said that this tour was something special. There were dozens of children and their parents who ran through the alleyways of Nahlaot, most of them African asylum seekers, and some Israelis. At the Community Center the community social worker told them about the different activities and services available there, and invited families to take part. At the Barbur Gallery the children made plants in the community garden and the director told them about the place itself and the community gardens in the area.

Naomi Roff2016-12-14T19:19:42+00:00June 8th, 2015|Asylum Seekers, Blog, Cultural Competence, Cultural Competence in Health Services, Identity Groups and Conflicts|

Working with Maccabi Health Services

What if all Israeli kupot holim (HMO’s) were culturally competent, from the bottom up and from the top-down? What if every time you went to the doctor, he or she – and the administrative support staff – would be better able to meet your needs, speak in your native language (or have access to someone who could), understand where your coming from, culturally speaking?

Since the Israel Ministry of Health published its directive in 2011, requiring all health care institutions to become culturally competent, things have improved, but there’s still a ways to go. Slowly, one HMO at a time, we’re helping to rectify the situation. We’ve been working with Jerusalem-based clinics and hospitals since the beginning of the Cultural Competency project in 2008 (this is the earliest blog post on the project). Last year, we began working with the Leumit HMO on a national level, the first time we had worked with national management and not primary clinics. In late 2014, we also began working with the national level of Maccabi HMO.

Maccabi seminar

We began with a 3-workshop introductory course that took place in December – January in Maccabi’s central instruction center in Tel Aviv. There were 25 participants, from all disciplines in the HMO – from nurses and physicians to administrators on different levels – from all over the country. During the course participants learned tools that will enable them to integrate principles of cultural competency into different aspects of the health organization. They also heard a lecture from Prof. Leon Epstein, one of the major researchers whose research serves as the basis for our cultural competency project , about the connection between society and culture on health an sickness. Dr. Anat Jaffe, Head of the Endocrinology and Diabetes Unit at the Hillel Yaffe Medical Center and a founder of the Tene Briut organization, shared her experience providing culturally competent care to diabetes patients from the Ethiopian community. Participants also learned from a “Community Panel,” in which different cultures’ approaches to health and health care were presented (Haredi, Ethiopian, Muslim, French).

Maccabi panel full room

Each of the participants was asked to develop and implement a project in the district or clinic in which he or she worked that would advance cultural competency. Examples included: an information sheet directed at Haredi women on sexual assault; a “Your Health is in Your Hands” handout, which lists the different recommended tests; a clinic that is accessible to French speakers; encouraging Muslims to use physical therapy through quotes from the Prophet Muhammad; engaging a volunteer to help fill out forms for Russian or Arabic-speakers; a public awareness meeting on diabetes, adapted to the needs of Russian speakers, and more.

Last week, on April 29, we held a follow-up conference for these participants. The meeting included a tour of the ALYN Pediatric & Adolescent Rehabilitation Center in Jerusalem, the first hospital in the country to undergo the cultural competency process, with our mentorship. They saw first hand how they implement cultural competency principles on a daily basis. ALYN’s cultural competency coordinator also explained how the hospital and its staff copes with different social and political tensions in a culturally competent manner. (ALYN’s Director General Dr. Maurit Be’eri wrote about this here during last year’s Operation Protective Edge.) In addition, participants heard a fascinating lecture by the director of the municipal welfare office in a Haredi neighborhood, on how to create a community context, especially during times of crisis. Her office was at the center of a crisis in mid-2009 when a Haredi mother was accused of starving her child. Out of this crisis arose a process of culturally competent work that includes local rabbis, community leaders from the Eidah Haredit, and different public offices that enable the welfare services in this area to be culturally sensitive to the Haredi population. Participants also heard updates of their respective projects.

Naomi Roff2017-05-26T20:04:47+00:00May 5th, 2015|Blog, Cultural Competence, Cultural Competence in Health Services, Ethiopian Jews, Identity Groups and Conflicts, Jewish Religious Denominations, New Immigrants, Palestinians/Arabs, Ultra-Orthodox Jews|

Happy Passover – Happy Easter – JICC Information Sheets from the Cultural Competency Desk

Pesach Kasher ve’Sameach and Happy Easter! May you never need medical care, but if you do, in Israel, we at the Jerusalem Intercultural Center (JICC) are making sure that medical staff at hospitals as well as other health care frameworks are aware of your Jewish, Christian or Muslim holidays . Since 2013 we have been writing one-page information sheets on different customs and traditions of a wide range of religious and cultural holidays (and wrote about it here and here) and have continued to refine and expand their scope. Today this includes not only the “major” holidays of the three Abrahamic religions, such as Yom Kippur, Passover, Christmas, Easter, Ramadan, Eid el-Adha, but also holidays celebrated by particular cultural groups, such as Sigd for Jews of Ethiopian origin, and Novi Gud, celebrated by residents from the former Soviet Union, and Eid a-Nabi SNabi Shu’ayb for the Druze. In all, there are over 20 information sheets that were written or revised in the past year. Here is the full list, in Hebrew.

Nabi Shu’ayb Druze Holiday Sheet

These information sheets have a huge audience. They are distributed on a national level, not only to clinics, hospitals and other health care institutions, but they are also adapted and sent to welfare agencies and organizations as well. We see this as one more step in increasing understanding and opening communication lines of communications between the widely diverse populations in Jerusalem and Israel.

Naomi Roff2015-04-21T19:07:21+00:00April 6th, 2015|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|

Cultural Competency Training for Hundreds of Staff at Central Jerusalem Branch of Maccabi Health Services

A few weeks ago we finished cultural competency training for over 200 staff at the main Jerusalem branch of the Maccabi HMO. This consisted of one-day (8-hour) seminars each with 20 – 25 participants each. This was our “standard” one-day introduction to cultural competency, that included theoretical and practical learning of cultural competency – cross-cultural communication, , medical interpretation, dealing with social and political tensions and more. Since these workshops sought to concentrate on providing culturally competent services to the Haredi population, in the afternoon session a medical actor and Haredi Rabbi joined us, and we practiced real-life situations. Central to the discussions was the “triangle” in Haredi society that connects between medicine, Jewish law (halachah) and Haredi culture. These workshops join other workshops that we’ve conducted in Jerusalem for the Clalit Health Services (see here for earlier blog posts), and Meuchedet Health Services (see here for earlier blog posts).

Maccabi Jerusalem

The seminars took place between October 2014 and February 2015, and encompassed a wide range of disciplines – medical and paramedical staff, as well as administration. Participants were quite enthusiastic. One remarked, “Cultural competency is the a-b-c of quality service, and it incorporates values that help us to provide the highest quality of services [to all patients].”

Naomi Roff2015-04-21T18:54:20+00:00March 15th, 2015|Blog, Cultural Competence, Cultural Competence in Health Services, Identity Groups and Conflicts, Jewish Religious Denominations, Ultra-Orthodox Jews|

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