Palestinians/Arabs | The Jerusalem Intercultural Center

Neighbors as Your Safety Net: Community Empowerment toward Emergency Readiness

Neighbors can be problematic (click here for a recent post about such neighbors), but they can also save your life, especially in an emergency. In the Emergency Response Networks program in east Jerusalem, we are helping bottom-up grassroots initiatives of residents to build the skills and capacity for emergency preparedness.

Imagine an earthquake. Especially in an area such as east Jerusalem, where infrastructure is poor – roads are narrow and poorly kept on good days, many buildings and additions did not take into consideration building codes and safety standards.

There is no time. Buildings have crumbled. Pipes and gas lines might have burst, power lines might be down. People might be trapped, and time is not on your side. All around the world, experts say that for the first few days – the community cannot hope for rescue teams to come from somewhere else. The formal rescue teams are going to be busy, very busy.

The best solution for these first few days is a team of local volunteers, who are responsible for the Emergency Response Network of the neighborhood. This team is trained in advance. As a part of their preparation, they create a detailed plan to have in place. All relevant infrastructure and equipment in the neighborhood will have been mapped – the schools and other public buildings, the health clinics, ambulances and other medical equipment, bulldozers, trucks and other heavy machinery, everything possible in the neighborhood that might help in an emergency. All relevant professionals in the neighborhood will also have been mapped and coordinated – from nurses and doctors to social workers to construction workers and engineers. They will have been organized into clusters by a number of resident-cluster heads. The Israeli police and other rescue workers will also have been notified, so that they know who from the neighborhood is in charge and so that rescue efforts can be streamlined.

We’ve been working to develop such Emergency Response Networks for the past 3 years, and currently there are trained teams in the neighborhoods of Jabel El-Mukaber and Silwan, Abu-Tor and Sur Baher, covering tens of thousands of east Jerusalem residents (out of 300,000 residents in East Jerusalem). Today they undergo practice simulation exercises like those described above. An earthquake is just one example of such an emergency to be prepared for. The concept of local team based on residents is novel. Usually in Israel these “local teams” are based on professionals who work in the community. But many of them reside outside the community, and it might be that in an emergency such as an earthquake, they will find it hard to come. The intensive mapping of resources is also unique to East Jerusalem – in neighborhoods that were originally villages of a few large families, where most people knew each other anyway, mapping and recruitment of community members that have expertise and tools (As bulldozers) is easier.

But we were frustrated…. The current training model enabled us to cover just 10% of East Jerusalem over 3 years. So now, based on what we’ve learnt so far, we are improving our pace. Utilizing a ‘Train the Trainers’ methodology, we are on the brink of training teams in all east Jerusalem neighborhoods over the next 2 years. Starting next week, on May 20, we are supervising the training of 12 Emergency Response Network trainers. These leaders had been trained before to be in their own local emergency team; now we are training them to train others. When these trainers complete the 40 hour course by the middle of July, they will then be able to organize and train volunteers in each of the neighborhoods, and survey the physical and human infrastructure in the neighborhoods. That work will take time (albeit, much less than in our previous model), but the results will be well worth the wait.

What is fascinating about this project is that neighborhoods do not only learn to save lives and save their neighborhoods in the case of an emergency. They also get to know one another and pool local resources. They are been empowered to help their community, whether they are doctors, social workers, teachers or construction workers. They are their own safety net. In the week of flood this winter (that ended with a full-blown snowstorm), these teams helped a lot in solving local problems of closed roads etc., whenever the citywide limited resources could not get in. This week showed the importance of these networks, even without major emergency situation.

Naomi Roff2014-04-11T16:06:59+00:00May 15th, 2013|Blog, Identity Groups and Conflicts, Palestinians/Arabs, Silwan Community Dialogue, Tsur Baher Community Dialogue|

MiniActive – Becoming Part of the Solution

MiniActive started ‘small’ (here’s its genesis story), with tens, hundreds, and now nearly 1,000 women monitoring and fixing everyday problems – street lights, potholes, garbage collection. We’re super proud of the magnificent growth this program has shown over the past few months, and of the dozens of sanitation and infrastructure problems the project has taken care of over the past few months in East Jerusalem (and the hundreds more that are in the pipeline). But the 3 first aid courses that finished last week is a slightly different example of how this grassroots initiative is quickly organizing solutions to critical problems.

The problem: a severe dearth of people qualified to accompany school trips as medics (which is required for school groups). That’s not to mention a general lack of knowledge about general first-aid procedures in the general public.

Learning CPR

Some 50 women participated in the 20-hour courses from all over East Jerusalem. Of these, 20 were chosen to study in a 60-hour course that will qualify them to accompany school trips. The course was taught, voluntarily, by professionals from the Emergency – Welfare, Assistance, First Aid and Response organization, which is associated with the United Hatzalah organization.

Thank you, teachers, for the donated hours. Thank you, women, for your willingness to step up and be a part of the solution. We’re sure this is just the beginning.

Instructor teaching first aid

Naomi Roff2014-04-11T16:05:25+00:00April 15th, 2013|Blog, Effective Activism, Identity Groups and Conflicts, MiniActive, Palestinians/Arabs|

MiniActive – Weathering the Storm

We began the MiniActive program as a small, grassroots empowerment program. What we got was a social change empire!

Example: Last week’s winter storm. We don’t remember when we had such a storm. It had it all – heavy rainfall, strong winds, and, at the end, lots of snow. More importantly, it cause lots of infrastructure problems that stopped up the whole city. In East Jerusalem, because of appallingly poor infrastructures, apartments and houses were flooded, electrical and telephone lines were knocked down, and many streets were blocked because of fallen trees.

Floods outside the Old City

Enter the MiniActive women. They had already become adept at calling and communicating infrastructure problems with the municipal 106 complaint hotline. (See here) Many of them did not have electricity or telephones themselves. Liana, the coordinator, declared a state of emergency, dedicating the whole network to work to fix problems created by the storm. Five of them came to our offices on Mt. Zion to help Liana coordinate the complaints and handle the more difficult problems, and they went to work, utilizing the hundreds of women in the networks in the field.

Damage in A-Tur

And boy did they go to work! In a flurry of activity, they were in contact with the 106 municipal hotline, the electric company, the phone company, the water company. They became critical sources of information for these bodies. Our offices were abuzz from morning till night – with telephones, faxes, e-mails and Facebook posts – but most of the activity took place outside the office. On the day of the snow, Liana couldn’t get to the office. Instead she managed the whole operation via her iPhone. In just 48 hours the network reported 3,000 issues and tracked their resolution.

Ceiling of house that needed to be repaired

One case included moving a family whose house had been flooded and who has a handicapped son to a safer location. Another was making contact with the proper authorities for a woman in Abu Tor who was about to give birth during the snowstorm. (She was transported safely to give birth in the hospital.) A third was contacting the Municipality to deal with walls that had fallen into the street as a result of the storm. In yet another case families whose houses had been flooded were moved to alternative housing until they could return home. Without this information, the welfare department would have had had no idea how to locate the families.

Working to fix phone lines after the storm

We can only take our hats off to the MiniActive women, and thank them for their energy, persistence, and drive. Kul El-ihtiram! Shukran! (Bravo! Thank you!) And now, a glimpse of Jerusalem covered in snow:

Naomi Roff2014-04-11T16:02:38+00:00January 15th, 2013|Blog, Effective Activism, Identity Groups and Conflicts, MiniActive, Palestinians/Arabs|

MiniActive in East Jerusalem and beyond – meeting with the municipality hotline

About two weeks ago we brought together the director of the 106 municipal hotline, as well as some hotline workers, and about 20 leaders of our MiniActive groups, mostly from East Jerusalem.

In order to fully understand the importance of this meeting, we need to first explain what MiniActive is.

The process began several years ago, when we first became interested in activism in Jerusalem in the context of the different groups in the city and their ability to influence the public sphere. As we became more and more familiar with the field we got the impression that too much activist activity we saw was not effective. People go to demonstrations that people hardly know about, and return home with the feeling that they’re activists. People sign petitions that don’t lead anywhere and feel that they’re activists. People ‘like’ causes on Facebook and feel that they’re activists. In too many cases, the only result of an ‘activist’ protest is that one day the participants will be able to say that ‘we were there and we were right.’ But we are interested in activism that causes social change and too often activist action doesn’t lead to this. We tried, in our JICC meetings, to get to the root of what makes activism effective – that which causes social change – and we came across a number of insights. We even prepared a lecture on the subject. But then it became clear that there is nothing less effective than a lecture about effective activism….the message was seemingly projected, but it did not significantly influence those who are listening to the lecture.

Last year’s summer protests brought us back to the subject. And then, from conversation to conversation a new idea was born: a workshop that we call “MiniActive“. At its core is a group of a number of people (today we know that the most effective size of the group is 5. But this might change), and each one is to choose a personal challenge that he/she is passionate about and has taken responsibility to resolve. This challenge must have a decent chance of being achieved within a time frame of 4-6 weeks. This enables each participant real feedback in a reasonable amount of time to examine what works and what doesn’t work for him to achieve his specific goal. An additional condition, in order to increase the activist learning curve, is that in order to resolve the challenge, other bodies or people must be engaged (the municipality, the post office, the neighborhood grocery store, tenants’ association, etc.) A diet is undoubtedly an important challenge…but it is not appropriate for a MiniActive workshop because there is no learning that deals with influence on a social system or on other people. On the other hand, a MiniActive challenge could be to fix a broken street lamp, cause garbage to be collected, enable an area to be exterminated against fleas or rats, fix an unsafe handrail in a neighborhood school, teach a teacher that yells in school to talk more quietly, show a tenants association how to function well….etc. etc. A MiniActive challenge can be all the little – but important – things that we complain about but no one ever takes up the gauntlet to solve.

Within the framework of the workshop, the group meets every week (here too, there are variations), and each person gives an update on what is happening with his or her challenge. The fellow participants are supportive, make constructive suggestions, and mainly, laugh together. Yes, laugh. Today we know that the social side is critical here. It greatly helps if the meeting looks like a social get-together, people sitting around and shooting the breeze and talking about their problems. But we don’t get stuck in the complaining stage. In addition to creating functioning MiniActive workshops, our fantasy was that the graduates of the workshops would establish additional groups and lead them themselves, with a little bit of support and consulting. And of course, some of the graduates would do more and more MiniActive projects and even ‘graduate’ to Midi-Active and Macro-Active…

So we began, and it wasn’t as simple as it sounds. We learned that it works better when the group is ‘next door’ and / or when the group works in the same geographical area, so that beyond the learning experience, one can really see the differences that occur in that area, simply because 5 people caused them to happen. But the pace of the development of the MiniActive approach was not yet impressive.

And then Liana Nabeel from A-Tur in East Jerusalem entered into the picture and began working at the JICC. We were introduced to Liana through her participation in our Project Managers Course last year. The course included, as one of its parts, a MiniActive workshop, and Liana just completed the MiniActive challenges too early – i.e., from meeting to meeting – so that each time she needed to choose something else. We quickly brought her on board to the JICC, to the East Jerusalem Desk that Ezadeen Elsaad manages. The main challenge that we gave her was to establish MiniActive groups of women in East Jerusalem. We might not have explained it well that we meant 5-6 groups…

Within a few months, 35 – 40 groups were started throughout East Jerusalem, with 180 active women! Liana proved that beyond her activist abilities was her ability to maintain large groups of volunteers. Thus, in Wad Kadum (between Silwan and Jabbel Al-Mukaber) streets are now lit at night, garbage is being picked up more regularly and new garbage receptacles have been put in place. In parts of the Muslim Quarter of the Old City, the phone company, after decades, has fixed exposed and dangling telephone lines. (The electric company in East Jerusalem is our next challenge). In Wad Al-Joz, there were exterminations against fleas and rats, and the water company is beginning to take care of sewage and drainage problems…Just two days ago, potholes were fixed in Silwan, an initiative of the MiniActive women. A significant part of the groups were established by graduates of the first groups and are facilitated by them. And everything is done in a supportive, social atmosphere, a camaraderie of women. It sometimes angers the active male residents when they discover that their meetings, which include the community leaders, accomplish less than the energy that the women’s MiniActive groups create.

One of the important principles that we speak about is that in order to reach solutions effectively, one doesn’t necessarily need to fight the other side – people are surprised every time to discover good people who are willing to help on the ‘other’ side – in the Municipality, in the telephone company, etc. Because the Municipality’s 106 hotline (the equivalent of th American 311) is often the first step in taking care of a large part of the issues, it was important that the hotline would not see these women as annoyances, and that the women did not see the operators as the enemy who doesn’t want to solve the problems. The 106 hotline in Jerusalem is unique in Israel, having technology and work procedures that helps in municipality response to residents calls. It was important to create an encounter that would be the basis of a worthy relationship between the callers and the operators. In addition, if there were communication difficulties – there would be a way to fix them quickly.

As a reminder, we once helped this 106 hotline recruit more Arabic-speaking workers, but some recently left (this is expected; it is a job suited to university students), and there is again a shortage of Arabic-speaking operators at the hotline. Liana solved the problem with a unique solution – she would call the hotline in the morning to see if there is an Arabic-speaking operator, and if so, she would text all her participants that this is a day to call. We are of course helping again in recruiting workers, since a lack of Arabic-speaking operators is a difficult obstacle for these women, who really don’t speak Hebrew.

So, as we said, on Tuesday there was a meeting of MiniActive group leaders (about 20). They also included some from west Jerusalem, but much fewer than those from East Jerusalem. It was also an opportunity to thank the American Center in Jerusalem that helped in the process of creating the MiniActive Program. It was a meeting with a slightly unorganized, energetic dynamic – partly because it was necessary to translate everything between Hebrew and Arabic and back again, partly because the activists continued to try to solve more and more problems such as broken stairs in the Muslim Quarter. (What can you do? Once an activist, always and activist…) But in the end we achieved the result we set out to accomplish – enabling the activists and the operators to get to know one another and paving the way for an even more effective ability to stimulate change.

MiniActive project meeting at 106

In the days following the meeting, we noticed a significant change in the dynamics with the 106 hotline. If there were additional hiccups in communicating with the hotline they were solved quickly. The energy of the women in the groups and the effective activism they demonstrate In the past few days are creating solutions to many issues in their neighborhoods.

jicc2017-05-05T13:58:47+00:00November 25th, 2012|Blog, Effective Activism, Identity Groups and Conflicts, MiniActive, Palestinians/Arabs|

Assisting Medical and Paramedical Professionals in Receiving Certification from the Israeli Ministry of Health – an update and congratulations!

This is a follow-up to a previous post on this issue. Over the last year, in cooperation with the Jerusalem Foundation and the Community Services Division of the Jerusalem Municipality, we’ve been working to solve the both sides of the same issue regarding health care in East Jerusalem. On the one hand there is a severe lack of personnel in all disciplines that is certified to work in East Jerusalem. On the other hand, there are hundreds of graduates of academic programs, from universities in the West Bank or Jordan, who are living in East Jerusalem but are not able to work in their fields (or are working ‘under the table’ in those fields and are not receiving full salaries or legal benefits), because they did not pass the requisite certification exams given by the Israeli Ministry of Health.

We began this journey exactly a year ago, when we began to explore the issue in two disciplines: occupational therapy and nursing. We learned that the Ministry of Health needs additional Arabic-speaking workers in these disciplines, especially in East Jerusalem. We also learned that only 1-2 nurses and occupational therapists passed the exam each year.

We learned that the first problem was language – the graduates’ Hebrew was not good enough to pass the Hebrew exam, and that the Arabic translation of the exam was a very poor one. Moreover, all of the graduates had studied in English in their universities. Thus, even though it wasn’t their mother tongue, they preferred to take the exam in English. We then learned that the occupational therapy exam had become available in English two years previously, solving this part of the problem for them. In nursing, for some reason East Jerusalem residents had not been allowed to take the exam in English. We then met with officials from the Ministry of Health, who rather easily, agreed to let them take the exam in English as well.

With one obstacle behind us, we discovered that the graduates did not have access to the necessary learning materials – their own universities were far away, and only Hebrew University students have access to materials there and at Hadassah. This was actually very easy to resolve – we bought the books, and the graduates came throughout the year to study in our offices.

And then we discovered that there are occupational therapy materials that are only in Hebrew – position papers of the Occupational Therapists Association, as well as laws, which the students must learn. We translated these position papers into English and donated them to the Association’s web site. (We also received thank-you letters from other students in Israel who used our translations…) The laws were too complicated for us to translate, so we found a successful lawyer from East Jerusalem, who agreed to study the laws and explain them to the students, thus enabling them to learn the information.

We made contact with the relevant schools of occupational therapy and nursing at Hadassah, and convinced them to join our adventure. We then held a preparatory course in English for some 15 graduates in occupational therapy. On the day of the exam, which was held in Tel Aviv, we rented a bus for the participants. We didn’t want to take any chances of them being held up at security checks at the central bus station in Jerusalem. The result: 6 passed and became certified occupational therapists! Those who didn’t pass will sit for the exam at the beginning of November, and we’re keeping our fingers crossed for them.

In nursing, the story was much more complicated. The exam is very difficult, and the preparation requires thousands of practice multiple-choice questions on a number of subjects. The problem was that we didn’t have a reserve of questions that was suitable for the Israeli exam – Hadassah’s pool was entirely in Hebrew, and it would have been exceedingly expensive to translate them. Even proofing the translations would have taken forever. We dared to do something that many thought would not help – we used large question pools in English that are used for the American certification examinations (NCLEX-RN), which is different from the Israeli. At the end of each chapter, we gave the students a small number of questions in English, based on the Israeli exam. The assumption was that in the end it was the same ‘body’ of knowledge (with a number of differences in legal aspects and ethics and emergency room protocol and first aid), and even though the type of questions are different, this model helped. No doubt that we gambled on our unique approach – it turns out that no one remembers that there was ever a preparatory program for the Israeli nursing exam in English.

Before we began the nursing program, we gave a practice test to the participants and no one passed! That was our base point, quite frightening. During the course we gave another practice test in July, and 7 participants passed. A month later, 2 weeks before the official exam, we held another practice test and 12 passed. 12 new nurses in East Jerusalem, the number that usually passes in 8 years, is definitely an achievement, but we wanted more – there were 45 participants in the course! After the exam at the beginning of September, we waited and waited (it turns out that the Ministry of Health takes a month and a half to grade thousands of exams), and yesterday the results came in: 25 (twenty five) passed the nursing exam!!! More than 50% success rate! We are over the moon, I must admit. We really didn’t imagine in our wildest dreams that we would be so successful.

It is important to understand the significance of the success of the nursing program – a large part of the graduates have worked in East Jerusalem as nurses, but without certification, they could not legally perform many medical procedures. Many times they did those procedures anyway, because they had no choice, and without the enforcement of the Ministry of Health. Now, their status is different, and with justification – they learned so many essential things in the preparation program that were important to their work, regardless of the examination. By the way, their salaries are also supposed to jump significantly. So it is good for them, and it is good for the residents of East Jerusalem – who will receive better health care in the clinics and hospitals in East Jerusalem. If we continue this trend, the legitimacy for these institutions to employ uncertified nurses will decrease drastically.

What’s next? There are many things that must be done – continuing the same disciplines and creating a sustainable system of preparatory courses for certification, as well as entering into additional professions – physical therapy, speech therapy, and more. And maybe we’ll succeed in areas that aren’t in the field of health care? We’ll know in time.

jicc2014-04-11T15:42:01+00:00October 23rd, 2012|Blog, Cultural Competence, Cultural Competence in Health Services, Education, Employment, Employment Accessibility, Identity Groups and Conflicts, Palestinians/Arabs, Supporting employment in East Jerusalem|

Assisting Paramedical Professionals in Receiving Certification from the Israeli Ministry of Health

Here’s an example of how our work in one area uncovers more and more needs in East Jerusalem, and opens up more opportunities to begin to close the gap in services to Palestinian residents of East Jerusalem.

We spent a long time working toward the opening of a Well-Baby Clinic in Silwan in August 2011. While working on the issue of opening more clinics, we discovered that there was a severe lack of Arabic-speaking nurses who were certified by the Israeli Ministry of Health. It meant that these Well-Baby Clinics in East Jerusalem and other healthcare institutions find it hard to find good certified nurses. The employment authority of the Municipality looked into the matter, and discovered that the problem was much larger – in general there is a dearth of Arabic-speaking medical and paramedical personnel, certified by the Israeli Ministry of Health, in East Jerusalem.

We also discovered that there are hundreds of graduates of Palestinian universities and colleges in the West Bank (for example, Bethlehem University, the American University of Jenin), who cannot work in their fields in the Israeli healthcare system. These institutions are considered ‘overseas’ institutions, and graduates must pass Israeli Ministry of Health certification and competency exams. (Israeli graduates must pass these examinations as well.) Very few Palestinian graduates from East Jerusalem pass these examinations. Paradoxically, the Israeli Ministry of Health is eager for these graduates to find work in the Israeli healthcare system in East Jerusalem, to reduce the above-mentioned lack of Arabic-speaking medical and paramedical professionals.

A preparatory meeting of nursing school graduates in East Jerusalem

A preparatory meeting for nursing school graduates in East Jerusalem

The Jerusalem Foundation, our long-time partner in creating cultural competence in the city and in creating better opportunities to all in the city, asked us to enter into the picture. Much of the initial work was investigative: we first sought to figure out the real obstacles that prevented Palestinian graduates from passing the examinations, and then proposed responses. At the outset we chose to concentrate first on occupational therapy and nursing. As part of this extended learning process, in November 2011 we held public meetings for each of the professions, which included relevant information about the certification process. Most of the participants had previously failed the exams, and they became integral partners in our learning process of constructing a full picture of the current situation.

The results were fascinating – and yet, typical – of many of the difficult problems that we have encountered, whose sometimes solutions were relatively simple. Indeed, we find many times that what looks as huge barriers can be overcome by simple solutions. Let us share these results and the response we suggested with you:

In occupational therapy, it turns out that until very recently, the exam was available only in Hebrew and in Arabic. Yet, the problem was that the Arabic translation was very poor, which hurt candidates’ chances of passing. More importantly, at Bethlehem University and at the American University in Jenin, the students learn in English! Thus, they would be much more comfortable taking the exam in English. Fortunately (unrelated to our work), in the past year students have been able to take the certification exam in English as well.

But this was only the beginning of the story. We discovered that part of the required material for the exam included position papers in occupational therapy that exist only in Hebrew; knowledge of Israeli laws, which is also available only in Hebrew; and the guidelines for occupational therapy in Israel, which exists in Hebrew, Arabic and English, but that the students knew nothing about! In other words, the Palestinian graduates were sitting for exams, for which they did not have access to or did not even know about significant parts of the material. Many graduates received scores between 50 – 60 (passing is 60), and this is without knowing about a good deal of the required materials.

This information enabled us to respond quickly. We translated the position papers into English (the language preferred by the graduates for the exam); we obtained guidelines for occupational therapy in Israel in English; with assistance from the Hebrew University Hadassah School of Occupational Therapy, we developed a program to prepare graduates for the exam that will take place in June 2012. This program began a week ago with 17 dedicated participants. The course will include 11, 3-hour meetings as well as 2 concentrated days as the exam nears.

Our follow-up is both group and individual – we purchased occupational therapy textbooks that are important for the exam, and participants will be able to use these materials. We helped each and every one of the participants register for the exam with the Israeli Ministry of Health, and more. We are very optimistic, but we will of course be calmer after the results of the June 2012 exams are released…

The situation in the field of nursing was more complicated. Here, too, graduates from East Jerusalem could take the exam in only Hebrew or Arabic, with very poor achievements (1-2 graduates passed the exams each year). The exams themselves are considered difficult – many graduates of Israeli universities also fail the exams each year. After a meeting with the Ministry of Health, it was clarified that from now on it wouldn’t be a problem for East Jerusalem residents to take the exam in English. Thus far we’ve given some 50 nursing school graduates a pre-test, similar to the real examination, to find out what we need to concentrate on in the course. We identified that 20 received between 50 – 60 on the pre-test (60 is the passing grade). This result encouraged us, since the graduates didn’t have much time to study, and if such a large group is so close to passing, the chances of at least 15 passing the certification exams in September after a program of intensive preparation and study, are good. In addition, we learned from the exams on what areas we need to focus more in the preparations.

Based on this information, a preparatory program for Palestinian nursing school graduates is being developed to prepare them for the government exams in September 2012. It is important to note that those who pass the nursing examination in a language other than Hebrew must also pass an additional exam in Hebrew language in order to receive a license to be a nurse in Israel. Yet, the Ministry of Health allows East Jerusalem residents who passed the exam not in Hebrew to work in Palestinian institutions in East Jerusalem. This means that those who pass the exam would only be able to work there. Although there is also a severe lack of personnel in East Jerusalem, we hope to provide participants in this course with Hebrew instruction, so that they will be fully qualified to work in nursing, anywhere in the healthcare system in Jerusalem.

We will be following these women and men through the examination and (hopefully) placement process. We hope that at the end of this process we will not only helped dozens more people receive employment in their chosen professions, we will help more of the 280,000 Palestinian residents of East Jerusalem receive better health care.

jicc2014-07-11T09:19:43+00:00April 15th, 2012|Blog, Cultural Competence, Cultural Competence in Health Services, Employment, Employment Accessibility, Identity Groups and Conflicts, Palestinians/Arabs, Supporting employment in East Jerusalem|

“Haaretz” article on our interpreters course in Bikur Holim: medical staffers are learning Arabic, Yiddish and more and learning cultural sensitivity to bridge gaps with communities in need of care

Following our interpreters course at Bikur Holim(see our blog entry about it!), Haaretz published an article that covers the story.

You can find the Article in English here, and the Hebrew version here.

We loved this excellent article very much. But we have two minor comments:

The English headline is misleading – it says “To give better care, Israeli doctors learning Yiddish and Arabic”. Well, this course was for bilingual staff who already speak two languages, but need to learn the professional tools for medical interpretation. We are very happy to see that medical staff is learning the languages of their patients, but frankly, we prefer that they use expert medical interpreters rather than relying on the basic language course they had.
We do not recommend saying “Abi gezunt” to a sick person…. it means “health is the most important thing”. You use this phrase when someone lost money or when his/her car was damaged in a car accident. The idea is that never mind the money – health is much more important. It is a bit cynical to say it to a sick person. Better use “Sei gesund” (be healthy). 🙂

Yet, great article! Here is the full text:

To give better care, Israeli doctors learning Yiddish and Arabic
Medical staffers are learning Arabic, Yiddish and more and learning cultural sensitivity to bridge gaps with communities in need of care.
By Dan Even, “Haaretz”

“Abi gezunt” (be healthy ) is a common refrain used by members of the ultra-Orthodox community in Jerusalem when fulfilling the religious commandment of visiting the sick.

But patients from the mostly Yiddish-speaking community who need medical treatment sometimes find it difficult to communicate with the doctors in Hebrew, which they use for prayers only.
Doctor with translators

A doctor and two translators simulating a Russian-Hebrew conversation.
Photo by: Olivier Fitoussi

In the past decade there has been an increasing awareness in Western countries of the importance of training teams in medical interpretation, in order to improve communication between doctors and patients from different cultures.

The medical system in Israel, an immigrant-absorbing country, has also recently instituted a special training program. After the opening of interpretation courses in Arabic, Russian and Amharic, last month a first course opened in Jerusalem to train interpreters in Yiddish.

“The Israel health system is good, but the issue of cultural competence has skipped us as though it never existed, maybe because it sounds too political or too leftist,” said the director general of the Jerusalem Inter-Cultural Center, Dr. Hagai Agmon-Snir, who initiated the program.

“Maybe it’s because of the melting pot concept, which led to a belief that if a patient speaking a foreign language arrives at the hospital, it’s preferable that he make an effort to speak Hebrew,” said Dr. Michal Schuster, a graduate of Bar-Ilan University’s translation studies program, who is participating in the project.

The interpreters’ course that began in May for the staffs of the Bikur Holim Hospital in Jerusalem was designed to train medical interpreters in Yiddish, the mother tongue of the ultra-Orthodox patients who use the medical institution. On the obstetrics wards, for example, 80 percent of the women are Haredi.

“It’s no secret that as opposed to the ‘State of Tel Aviv,’ here we have patients from specific populations, and there are patients from the Haredi and Arab populations who are in need of a sensitive attitude in various medical situations,” said the medical director of Bikur Holim, Dr. Raphael Pollack. Agmon-Snir says while the patients know a little Hebrew, they shouldn’t have to stumble for words when in a hospital setting.

“Theoretically there’s no need for interpreters into Yiddish, but there are members of the Haredi community who are capable of expressing their distress more easily in Yiddish, and we should make communication easier for them,” the doctor said.

The language training consists of 40 academic hours over a period of six weeks, and is being taught to 36 Bikur Holim nurses and administrators. The course includes introductions to anatomy, in order to become familiar with common medical terms such as EKG or blood count, the study of precision in translating and of medical ethics. The cultural competence course, which is designed for a larger number of staff members, also includes content related to the cultural differences among patients of different origins.

Schuster says that they make sure not to perpetuate stereotypes about minority groups, “instead, we provide tools for dealing with a patient from a different culture, principles of listening and understanding the cultural nuances,” she said.

Shake hands

“In the Ethiopian community, at the beginning of treatment the doctor is supposed to stand up and shake the patient’s hand,” says Dr. Idit Dayan, the coordinator of welfare at the Jerusalem Foundation, which is a partner in planning the project and promoting cultural competence in the Jerusalem health services, and supports it to the tune of hundreds of thousands of shekels annually. “There are Russian doctors who confessed to us that they don’t understand the custom, but it constitutes a code of honor in the Ethiopian community, and it helps to improve communications and breaks the ice between the doctor and the patient.”

Cultural misunderstandings are liable nowadays to lead to medical negligence claims, and Israeli courts have already dealt with scenarios originating in an absence of cultural competence on the part of medical staffs.

In January 2007, the Jerusalem Magistrate’s Court granted compensation of NIS 250,000 to a couple from Bueina-Nujidat in the north, after the woman miscarried and claimed that at Poriya Hospital, where she was under supervision, they were negligent in treating her.

It turned out that during the period of supervision the woman, who is an Arabic-speaker, was given medical explanations in Hebrew. One of the doctors testified at the trial that she had given the expectant mother explanations in Arabic, but it turned out that she had explained the nature of the treatment the woman required at home using only isolated words rather than sentences.

In the ruling, Judge Arnon Darel said “the hospital did not meet its minimal obligation of providing the explanation in a manner understandable to the patient.”

The present project began in 2008 with the support of the Jerusalem Foundation, and continued with a pilot in the Alyn Pediatric and Adolescent Rehabilitation Center, when staffs were trained in medical interpretation and directional signs in various languages were posted.

The project has since expanded to the Clalit health maintenance organizations in Jerusalem, especially in the clinics that serve the Ethiopian community, and the Arab community in East Jerusalem.

In the past year the program was also expanded to Hadassah University Hospital at Mount Scopus and at Ein Kerem, and is slated to also be used at the Kfar Shaul Mental Health Center.

The profession of medical interpretation is still in its infancy in Israel, but the vision for the future includes the development of a new career path. At Alyn there is already a salaried Arabic interpreter. The increasing awareness of cultural differences and the fear of lawsuits have led the Health Ministry to publish a director general’s circular on the subject of cultural and linguistic accessibility in the health system.

According to the circular, by February 2013 all the institutions in the health system will be required to provide medical translation services to patients by means of a professional hotline, by employing cultural experts or by employing staff members who speak foreign languages, after they undergo training, and to refrain insofar as possible from using a family member as a translator.

jicc2014-07-11T09:12:02+00:00July 4th, 2011|Blog, Cultural Competence, Cultural Competence in Health Services, Ethiopian Jews, Identity Groups and Conflicts, New Immigrants, Palestinians/Arabs, Ultra-Orthodox Jews|

Speaking Art Conference: Triggering Activity year-round – Follow-up Meeting on June 2011

By Naomi Roff Kohn, The Jerusalem Foundation:

Published at the Jerusalem Foundation site.

Understanding Each Other Through Music
June 2011

The Speaking Art Conference, held every December for the past seven years, is an opportunity for Jewish and Arab artists in the field of music, theater and dance to work together, thus getting to know other performing arts projects from different cultures and groups throughout Israel.

In order to strengthen the impact of the conference and to increase continuity from year to year, the Jerusalem Foundation and the Jerusalem Intercultural Center (JICC), have begun to hold mid-year meetings, bringing the artists together for shared activities, to strengthen their bonds and friendships, and to discuss suggestions for the next festival.

On June 16, 2011 some 20 Jewish and Arab artists participated in the mid-year meeting with a jam-packed day. It started with a workshop by Shmuel Hadjes, founder and director of the Jerusalem-based Psik Theater, and Hisham Suleiman, founder and director of the Nazereth Fringe Theater, entitled “The Internal Conflict.”

Speaking Arts workshop at the JICC house – June 2011

Musicians continued their work on a text they prepared during the last conference while other participants discussed how their religious and national identity influenced their work as artists.

After lunch the group visited the Al-Ma’mal Foundation for Contemporary Art in the Christian Quarter of the Old City, to broaden participants’ familiarity with the art scene in east Jerusalem. Since many of the participants were not from Jerusalem, the group also toured the Christian and Jewish Quarters of the Old City and visited holy sites such as the Church of the Holy Sepulchre.

Discussions were held on how the November annual event can be improved, expanded, and strengthened.

The day ended with an one-hour concert of the Jewish-Arab band Na’am in the JICC’s garden. The participants gathered around the band, listened to the music and it was a wonderful end to an enriching day.

Evening Concert at the JICC garden – June 2011

A clip of the afternoon concert at the JICC beautiful garden (thanks to the Jerusalem Foundation):

Original at: http://youtu.be/wdt3eUPn9xY

jicc2017-05-02T07:57:43+00:00June 16th, 2011|Arts, Blog, Identity Groups and Conflicts, Jewish-Palestinian/Arab, Palestinians/Arabs, Speaking Arts Conference|

First time in Yiddish!! – opening of medical interpreters course in Bikur Holim Hospital

Today we began implementing our cultural competence program at the Bikur Holim hospital in Jerusalem. Bikur Holim is one of the oldest hospitals in the city (founded in 1826). From the article in Wikipedia about the hospital, we have chosen to cite the following:

Situated near the religious neighborhoods of Geula and Mea Shearim, Bikur Holim admits a very high percentage of Haredi Jews, and tries to cater to their needs. Shabbat is strictly observed. Non-Jewish employees record medical information and answer telephones on the Sabbath. Food is warmed in ovens operated by a timer, in keeping with Orthodox religious rulings.

The Haredi (Ultra-Orthodox) orientation of the hospital is very much known in Jerusalem. Yet, it is not surprising to find out that since most of the medical and non-medical staff are non-Haredi, there is still a need for improving cultural competence for Haredi patients and families. When we approached the hospital management, half a year ago, as a part of the program of cultural competence in Jerusalem (a program we share with the Jerusalem Foundation), we were warmly invited in. The staff also emphasized that the hospital accepts patients from all around the city, including high percentage of Palestinians (Muslims and Christians), new immigrants from all around the world and migrant (foreign) workers. Together, We planned a cultural competency program for the hospital.

Bikur Holim Medical Interpretation Course

The first step of the implementation was today – a medical interpretation course for more than 30 bilingual staff members. Well, we did such 30-40 hour training courses before, in Alyn hospital, in Clalit HMO and in Hadassah. But this time, in addition to Arabic, Russian and Amharic interpreters, we have a large group of Yiddish interpreters! Indeed, although most of the Haredi community can speak in Hebrew, many of them are much more used to Yiddish, and Hebrew for them is a kind of a second language. Also, medical terminology and explanations in English or in Hebrew are hard for many of them to understand. We believe that using Yiddish can help many of them and would make them feel more “at home” in a Western hospital.

Bikur Holim Interpretation Course – on the left Rabbi Shlomo Pappenheim, main Eda Haredit Leader and a Board Member of the hospital

Definitely, if this works well, we will advise other medical institutes in Jerusalem, that also serve large Haredi populations, incorporate Yiddish into their list of interpretation languages.

The next step will be providing our staff training workshops of cultural competency. One of the urgent needs is to make Arab patients feel “at home” in a hospital that is seen as oriented towards religious Jews. With the help of the wonderful staff of the hospital, we are sure that this challenge can be met.

jicc2016-10-22T07:31:15+00:00May 25th, 2011|Blog, Cultural Competence, Cultural Competence in Health Services, Ethiopian Jews, Identity Groups and Conflicts, New Immigrants, Palestinians/Arabs, Ultra-Orthodox Jews|

Cultural Competence in Hadassah Mount Scopus – Free Interpretation Service for Patients and more

Please see the Hadassah Medical Center press release from today:

17/03/2011

Free Translation Service for Hadassah’s Patients

For the past few months, Arabic and Russian-speaking patients at Hadassah-Mt. Scopus have been able to avail themselves of a free and professional translation service, thanks to the collaboration between the Hadassah Medical Organization, the Jerusalem Foundation, the Jerusalem Intercultural Center and volunteers from the community.

Research has shown that a language barrier between a patient and a physician often impedes care and treatment – the physician does not fully understand the patient’s complaints and the patient does not fully understand the treatment guidelines.

A generous donation from the Jerusalem Foundation enabled the establishment of B’sfatcha Center (In Your Language Center). Prof. Leon Epstein, Director Emeritus of the Hadassah-Hebrew University Braun School of Public Health, initiated the project, which is headed by Gila Segev of Hadassah’s Department of Social Services, and staffed by 30 trained volunteer medical translators.

A similar service will be soon been established at Hadassah-Ein Kerem.

Indeed, in September Hadassah Mount Scopus began training Arab and Russian-speaking volunteers to become medical interpreters. The JICC provided the volunteers with a 5-day medical interpretation course and helped in recruiting the volunteers and in establishing the service, together with the dedicated staff of the hospital. To date, there are 34 volunteer interpreters who are available for daytime rotations. The interpreters serve in the gynecology, emergency and internal medicine departments, where they are most needed, but can be requested by telephone to help out in any area of the hospital. In November, the first month the interpreters were made available at Hadassah, there were 83 requests for their services. By January the number had risen to 121. In the beginning of February the total number of requests reached 300.

Hadassah created a wonderful clip about the service (in Hebrew only):

Original at:http://youtu.be/RB8gHYG8W6M

Version with English subtitles (thanks to the Jerusalem Foundation):

Original at: http://youtu.be/yecOi2BiDjE

At the same time, we provided training workshops to around 80 hospital staff members about the uses and capabilities of these interpreters, as well as about principles and practical tools of cultural competence.

jicc2017-05-02T07:53:56+00:00March 17th, 2011|Blog, Cultural Competence, Cultural Competence in Health Services, Identity Groups and Conflicts, New Immigrants, Palestinians/Arabs|

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