New Immigrants | The Jerusalem Intercultural Center

Cultural Competence Training – Talpiot Clinic – June 11 and 25, 2009

Today we finished a set of two training sessions on cultural competency in serving the Ethiopian community in Jerusalem. The training was delivered to all staff members of the Clalit Primary Care Clinic in the Talpiot neighborhood and was basically the same training as the one delivered to the Ir Ganim clinic. Our next step in the near future is to deliver the training also in the Gonenim and Neve-Yaakov clinics. By that we will cover all four clinics that serve the Ethiopian population in Jerusalem.

Talpiot Clinic Training 2009

It is important to note that following these trainings we continue to support the clinics in their efforts to give better and adapted services to new immigrants. In a follow-up process we found that many of the skills that were taught in the trainings are now being used in the clinics. In addition staff members report that patients demonstrate higher levels of satisfaction than before.

jicc2014-04-07T19:55:24+00:00June 25th, 2009|Blog, Cultural Competence, Cultural Competence in Health Services, Ethiopian Jews, Identity Groups and Conflicts, New Immigrants|

Ethiopian Community, Talpiot, May 13, 2009

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

Some of the Training Participants

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

Dr. Hagai Agmon-Snir at the training

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

jicc2014-04-07T19:21:14+00:00May 13th, 2009|Blog, Courses, Cross-Cultural Communication Trainings, Cultural Competence, Ethiopian Jews, Identity Groups and Conflicts, New Immigrants|

Cultural Competence Training – Ir Ganim Clalit Clinic (part 2) – March 23, 2009

Today we held the second part of our first workshop on cultural competency in serving the Ethiopian community in Jerusalem. The training was delivered to all staff members of the Clalit Primary Care Clinic in the Ir Ganim neighborhood.

Michal Schuster at the Second workshop in Ir Ganim Clalit clinic

This time we focused on the use of interpreters (telephonic and face-to-face) in the clinic, as well as learning how to work with a cultural liaison. The Ir Ganin clinic employs a part-time Ethiopian Cultural Liaison, funded by the Ministry of Health. We used simulations to improve the learning process.

Using a cultural liaison in a simulation

Building on the positive feedback we have received, this training will be provided to the other clinics that serve Ethiopian population in Jerusalem.

A nurse participating in a simulated case

jicc2014-04-07T19:16:21+00:00March 23rd, 2009|Blog, Cultural Competence, Cultural Competence in Health Services, Ethiopian Jews, Identity Groups and Conflicts, New Immigrants|

Ethiopian Community, Talpiot, March 12, 2009

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

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

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

jicc2014-04-07T19:14:12+00:00March 12th, 2009|Blog, Courses, Cross-Cultural Communication Trainings, Cultural Competence, Ethiopian Community - Talpiot Community Dialogue, Ethiopian Jews, Identity Groups and Conflicts, New Immigrants|

Cultural Competence Training – Ir Ganim Clalit Clinic – March 2, 2009

Following a strategic planning process for adapting Clalit’s clinics to Ethiopian patients, we held today the first workshop on cultural competence in serving the Ethiopian community in Jerusalem. The work with Clalit is a component of the Jerusalem Cultural Competence in Health Project initiated by the Jerusalem Inter-Cultural Center and the Jerusalem Foundation. In this project we aspire to make the Jerusalem district of the Clalit HMO much more culturally competent.

This specific workshop was delivered to all staff members of the Clalit Primary Care Clinic in the Ir Ganim neighborhood. The clinic serves 450 Ethiopian families, most of which arrived to Israel about 10 years ago. Our approach to cultural competence trainings, based on international experience, is to provide tools that will be relevant to other cultures in the neighborhood as well. Yet, in this training, emphasis was given to the unique Ethiopian case.

First workshop in Ir Ganim Clalit clinic

The Jerusalem Inter-Cultural Center has developed a training based on a series of case-studies. Some of the cases are raised by the participants themselves and others are formulated specifically for the training and presented by the JICC staff with the help of a professional medical actress. In Ir Ganim we were happy to work with an artist, Ethiopian by origin, that played the patient in these case simulations. Through the analysis of the cases, the participants learn relevant models and tools: how to create better patient-provider inter-cultural communication, cross-cultural communication tools, best ways to work with interpreters and tele-interpreters and, importantly, how to deal with culturally-oriented political issues that may divert the staff from its professional work. Our experience shows that in Israel, probably more than in other Western countries, political issues related to racism, religious coercion, and other inter-group tensions, may create major challenges to the staff.

Medical Ethiopian professional artist in the Ir Ganim training

The second part of the training in Ir ganim will take place on March 23. In the meanwhile, the feedback provided at the end of the training indicated that this was a very important and fruituil training experience. We all look forward to the next meeting.

Our next step following the training in Ir Ganim is to provide similar trainings in the rest of the Clalit Jerusalem district clinics serving the Ethiopian community.

jicc2014-04-07T19:11:01+00:00March 2nd, 2009|Blog, Cultural Competence, Cultural Competence in Health Services, Ethiopian Jews, Identity Groups and Conflicts, New Immigrants|

Fourth Training to Municipality Absorption Neighborhood Officers

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

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

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

jicc2014-04-05T18:01:27+00:00February 18th, 2009|Blog, Courses, Cross-Cultural Communication Trainings, Cultural Competence, Cultural Competence in the Workplace, Identity Groups and Conflicts, New Immigrants|

Third Training to Municipality Absorption Neighborhood Workers

On February 4, we held the third training in the series that provides the Absorption Workers at the municipality with an introduction to the field of Cultural Competence. The series covers topics such as organizational cultural competence, cross-cultural communication, tools for cultural competence, case studies and simulations.

In the training we continued and deepened our efforts to adopt Cross-Cultural Communication skills. This time, using the example of interaction between American guests and their hosts, their Israeli partners, we defined some of the main attributes of the Israeli manner of interacting and communicating. We applied these insights to interactions between Israelis who come from different cultural backgrounds, with an emphasis on new immigrants in Israel.

Next we examined positive and negative ways to judge behaviors of the “other” and how we can broaden the repertoire of behaviors that one can accept as legitimate. Yet, the main challenge is to find the bridge – to find the way to get the most out of the inter-cultural encounter. An interesting example was brought up by one of the participants regarding an Ethiopian couple who were supposed to go to the hospital for an important appointment that was set months in advance. At the last minute before their departure some of their family relatives showed up unexpectedly. According to their values and norms the Ethiopian couple had to host the guests. When they arrived to the hospital hours later the staff there were very angry with them.

At the training we took the opportunity to analyze this real life example, similar to many that we at the JICC encounter these days. We asked ourselves in which circumstances is it legitimate, in Israeli society, to arrive late to a medical appointment – e.g. death of close relative or a road closed because of a security threat. How would a “mainstream Israeli” act in order to ensure that she/he gets to the appointment even though he or she are late due to such reasons. We tried to work out how would it be possible for both sides – medical staff and patients – to get their interests and needs met in such a situation. This important example resonated with the training participants, who are exposed to similar cases in their daily work as service providers, and as those who try to help new immigrants navigate Israeli bureaucracy.

In the next meeting we will aspire to adapt medical models for inter-cultural dialogue with patients to the work of absorption officers and other service providers.

jicc2014-04-05T17:58:19+00:00February 4th, 2009|Blog, Courses, Cross-Cultural Communication Trainings, Cultural Competence, Cultural Competence in the Workplace, Identity Groups and Conflicts, New Immigrants|

Interpretation Success in Alyn!!!

Just a month ago, we concluded the first medical interpretation training in Jerusalem, for around 10 staff members of the Alyn Hospital. Training graduates are currently being utilized for interpretation only sporadically, in their “spare time”, while the Alyn management prepares formal regulations for putting them into service.

But reality frequently cannot wait for regulations to be written. Following a training to municipality absorption neighborhood officers, where our model for Cultural Competence in health was presented, one of the officers approached the JICC for help. He told us about a family that immigrated to Israel from Belarus in December 2008 with a child that needs to be diagnosed and probably operated on. They were invited to Shaarei Tsedek and Alyn hospitals but the problem is that they speak only Russian. The absorption officer remembered that we work with Alyn and asked if we could assist with proper interpretation there. What seems nowadays obvious in most Western countries is still a challenge in Israel 2009 – medical interpretation is rarely available.

We could not help with Shaarei Tsedek as we do not work with them (yet…), and the family recruited a family friend to help there. However, in the Alyn hospital the check up process is six hours-long – six different professionals need to examine the child – and the family friend, who is a senior citizen, could not come for such a long time. We called Alyn and updated them about the situation.

One of the most important aspects in our model of Cultural Competence in Health is the designation of a management member of the health system to be responsible for the assimilation of the process into the hospital. This person is also the liaison between the system’s staff, the community, the patients, and us. The liaison in Alyn acted rapidly. Due to different constraints it was not taken for granted that the hospital could allocate one of the Russian-speaking graduates of the training for the whole day. But understanding that otherwise the six hours of examination will go to waste, the staff worked hard to find a solution.

Today, the family arrived to the hospital with the child and for the whole day, the Russian-speaking interpreter accompanied them from one health professional to the other. In the afternoon, we heard the feedback from all sides. The Alyn medical team thought that the interpretation was crucial and helpful. The family was most grateful and the absorption officer said that they were not only pleased with the interpretation, but also about the way the interpreter expressed her empathy and willingness to help. The whole process improved tremendously the potential for the surgery, together with the follow-up treatment instructions given to the family, will improve the medical condition of this child.

For us, this was a great example for how our systemic work with cultural competence in health can help people. We hope that soon allocating an interpreter to a patient with language proficiency needs will not be news. Just a regular procedure.

jicc2014-04-05T17:53:50+00:00January 28th, 2009|Blog, Courses, Cultural Competence, Cultural Competence in Health Services, Identity Groups and Conflicts, New Immigrants|

Second Training to Municipality Absorption Neighborhood Workers

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

The meeting was oriented towards Cross-Cultural Communication. Using a couple of personal and team exercises each of the participants extracted the core values and beliefs that guides her/him in interaction with others. The experience helped participants see that these core communication factors are based on our cultural background and origin, and that when interacting with clients and colleagues of other cultures the differences might create cultural clashes.

The interesting insight that stemmed from the day was the realization that while we all accept various values and beliefs as important and valuable, each of us prefers some to the others and may translate them into different behavior patterns. Hence, if we allow ourselves to see the positive values behind someone else’s behavior, we may shy away from negatively judging them. This is an important step towards better cross-cultural communication.

We will deepen our cross-cultural communication skills in the next meeting.

jicc2014-04-05T17:36:14+00:00January 21st, 2009|Blog, Courses, Cross-Cultural Communication Trainings, Cultural Competence, Cultural Competence in the Workplace, Identity Groups and Conflicts, New Immigrants|

Ethiopian Community, Talpiot, Dec 4, 2008

On October 2 we reported in the blog on some achievements in the community dialogue process in Talpiot Ethiopian Community. The first was in solving the issue of language at the main HMO Clalit health clinic in the neighborhood. The second was the agreement by all relevant agencies to enable the Ethiopian community to have a weekend synagogue in a public location called Beit Hakehila (the Community Hall). These were certainly good news, although we estimated that the story was not over, and that other issues awaited their resolution in this neighborhood.

Indeed, during the holidays, a few issues challenged the mutual trust that needs to be built between the relevant stakeholders. The “weekend synagogue” model was found to be a source for many conflicts, some of which we have described in the previous blog posting. It is important to note that this model is used all over Jerusalem where religious communities are granted permission to use public facilities for their purposes, when these are not in use during the weekends, for example public schools. In Succot, although they were explicitly asked not to do so, the Ethiopian community built a Succah in the yard of Beit Hakehila. The municipality, which owns the place, perceives this and other incidents as violations of the ontract signed by the Ethiopian community for the use of the place. Since the episode occurred during the municipal elections campaign, municipality officials did not react this time. Politics, as we have seen many times in Jerusalem, is a significant player in the field. The elections have now passed and we will soon witness the next steps in this story.

And as if this is not enough, a new dispute emerged. The Ethiopian community asked that its members would be allowed to use another neighborhood public venue, Beit Lazarus, for private celebrations. It should be noted that in the Ethiopian community, religious life-cycle ceremonies (weddings, Bar Mitzvah, etc.) are a public event where the celebrating family invites all the community to participate. Having a public/private celebration in the middle of the village was an option in Ethiopia, but it is not so in Talpiot, where most of the residents are not Ethiopians. The alternative is to hold the celebration in a public facility, which the authorities allocate for that purpose. However, in Talpiot such a solution was not achieved yet and the community asked that celebrating families would be able to rent Beit Lazarus for their events. The community Council that owns the place did not approve the request, stating that this public facility cannot be rented out for private purposes.

Practically, the community asked to use the place on Dec. 5 and Dec. 12, and threatened to hold demonstrations and protests if their requests were not answered. Last week, we found ourselves – the mediating team of Mosaica and the JICC – in meetings and conversations with the head of the Ethiopian community and the heads of the relevant authorities. However, it seems that the current lack of trust, resulting from the contract violations by the community at the synagogue, prevents such negotiations from being productive. Our experience shows that what is currently required is a process, that will probably be challenging for all sides, for the examination of the events that happened in the last months as well as their consequences for the trust building process.

Additional meetings will take place this week trying to decipher the way to resolution.

jicc2014-04-05T17:10:20+00:00December 4th, 2008|Blog, Ethiopian Community - Talpiot Community Dialogue, Ethiopian Jews, Identity Groups and Conflicts, Inter-Cultural Community Dialogue, New Immigrants|