The Jerusalem Inter-Cultural Center Blog

Neighbors. Neighbors can be a problem, even in the best of communities. But what happens when neighbors move in who are very different from you? Or when old-time neighbors’ families grow and grow, and seem to be taking over the very nature of your neighborhood? From the ‘other’ side - you’re just looking to living in a nice neighborhood with your family - what’s all the fuss about?

This has been the dynamic in two Jewish neighborhoods - Rehavia and Kiryat Yovel - that we’ve been working in recently. Both are traditionally secular / national religious neighborhoods - in fact, they’re considered bastions of these populations in Jerusalem. Recently, Kiryat yovel has seen an influx of new Haredi residents. In Rehavia, there has always been a Haredi community, but in recent years more and more Haredi families were getting in the neighborhood, changing the demographics. In a city where the Haredi population is growing quickly and non-Haredi populations are feeling threatened, this can definitely cause tensions.

However, if one of our goals is to work to preserve a diverse Jerusalem, tensions are the last thing we need. So in an effort to assuage building tensions between the Haredi and non-Haredi residents of Rehavia and Kiryat Yovel, we’re working with 2 very special neighborhood forums.

In Rehavia, we’re working together with the local community council with a group of 20 Haredi and non-Haredi residents, many of them are the leaders of their communities. This includes a fascinating combination of young and older people, national religious, as well as Haredi and secular, men and women. By the end of the second meeting we’d come up with a Summary of Principles for working together. This of course doesn’t mean that individual - and sometimes far-reaching - issues have been solved. But right now we’re focusing on the ‘how we handle issues’, before we move on to the ‘what is the solution’. This includes sometimes basic statements, such as ‘live and let live’, ‘mutual respect’, ‘love of the neighborhood’ and an ‘emphasis that we’re all one people’. But we all know that when tension threatens to boil over we need simple, basic principles to guide us through. This group has met twice, and will continue to meet. It has been decided to significantly expand this forum, so that broader agreements can be made and more people and groups can be represented.

In Kiryat Yovel the situation is a bit different. The entrance of Haredi families, even as a small percentage of the population, has raised numerous battle cries against the ‘Haredization’ of Kiryat Yovel, which arises in various forms from time to time. The group in Kiryat Yovel is still smaller - 8 people, all are main leaders - and thus far the two meetings have consist of ‘getting to know you’ conversations. Yet, because Haredi-non-Haredi relations are much terser than in Rehavia, the very existence of these meetings is of utmost importance. While Kiryat Yovel is a tougher nut to crack, we believe we’re on the right path, creating a safe haven for dialogue and conflict resolution. In the last meeting, two Neighborhood Council members hugged each other at the end. This was an unusual occurrence, since one was Haredi and the other was secular who is very active against the Haredization of the neighborhood. “Finally, here, I can give you a hug,” said the Haredi Council member. Another, a secular woman, requested that Haredi women come as well, so that she wouldn’t feel lonely. Currently there is no other place this could happen.

In both neighborhoods, there is energy  to continue the processes, and a feeling of hope that is very important for the future of these communities, as well as for Jerusalem.

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.

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

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.

We are on the verge of yet another transformative process in the field of cultural competency. On March 14 - 15, the JICC was invited to present its introductory cultural competency workshops to 70 senior managers from the Jerusalem Center for Mental Health, at its annual management conference at the Dead Sea. This Mental Health Center includes hundreds of staff who are responsible for 300 hospital beds (active and extended stay departments) over 2 campuses (Kfar Shaul and Eitanim), Mental Health Centers in west and south Jerusalem, in Ma’ale Adumim, Mevasseret Zion and in Beit Shemesh. The Center also serves the Arabic-speaking population from East Jerusalem. The focus on cultural competency at the annual conference is a kickoff to the process of making the Jerusalem Center for Mental Health culturally competent. The Jerusalem Center was the first mental health center in Israel to commit, through the JICC help, to assimilate principles of cultural competency throughout its system of care.

Mental health services are a special challenge for cultural competency, since most care is based on verbal communication. At the same time, it is important to note that public mental health services are required comply with the Ministry of Health directive (February 2011) on cultural competency, as other health care organizations. In this conference the issue was introduced to the senior management, including department directors, as well as those in key roles, before cultural competence is being assimilated in all departments. The spotlight given at the conference is the result of many meetings between the JICC and the Jerusalem Center administration, as well as with the Jerusalem Foundation, to explain its importance in psychological care.

Practicing Dialogue

Throughout the first day the participants told stories about intercultural challenges and events they had encountered. In addition, Dr. Hagai Agmon-Snir, JICC Director, presented a workshop on intercultural communication and cultural dimensions and how awareness of this subject influences mental healthcare.

During the second day the participants were exposed to the importance of professional interpreting in therapy sessions, and shared examples, from Israel and around the world, of therapy being compromised because of language barriers. Senior staff understood the need and seemed willing to change the existing situation (which today uses non-professional and unskilled interpreters) to make the services more accessible. The day included a fascinating discussion about the boundaries of multiculturalism (”How much should I give up my professional and personal values in order to adapt the therapy session to the patient that comes from a culture that is entirely different than mine?”).

Workshop of the Jerusalem Center for Mental Health March 15, 2012

It was obvious that the 2 days of the conference were a first taste, and that this will be a long process that will require close cooperation between the JICC and the Jerusalem Center for Mental Health. The process will include training the medical and administrative staff in CC skills, and training bilingual staff in a medical interpretation, as has been done in other Jerusalem hospitals (Bikur Holim, Alyn, Hadassah) and HMOs. We believe that the products of this lengthy process can be a prototype for similar accessibility processes in other mental health centers around Israel.

Each year, our Speaking Art Conference for Jewish and Arab professionals in the performing arts gets better and better. This year, the 8th annual conference opened on November 16, which was also International Tolerance Day, and was held for two days at the Jerusalem International YMCA, the Beit Masia Theater and the Vertigo Studios at the Blaustein Civic Center. About 70 Jewish and Arab artists came together from all over Israel. This year, for the first time, 70% of the participants came from the Jerusalem area, the highest it’s ever been.

We’d like to thank the Dear Foundation and the Jerusalem Foundation for their ongoing support of the conference. The conference started with a workshop led by social activist Elad Vazana and renowned American choreographer Donald Byrd, followed by a guest workshop with famous singer Achinoam Nini (aka Noa) and guitarist Gili Dor. As part of the workshop, the participants engaged in a discussion with Nini and Dor about using music as a tool for dialogue between the Arabs and Jews.

After the opening, the conference participants engaged in either music, theater or dance workshops led by professional artists in their respective fields. In the workshops, the participants not only had the opportunity to take part in professional enrichment, but were also able to unite with their Jewish and Arab colleagues to learn from them and to create dialogue through art and creativity.

The Jerusalem YMCA hosted the music workshop led by composer, musician and singer Sameer Makhoul. The group played a variety of songs together and explored other cultures through the songs.

The theater workshop was held at Beit Masia in conjunction with Jerusalem’s Psik Theater. Led by Hisham Suleiman, a director, actor, playwright and founder of the Nazareth Fringe Theater, and Shmuel Hadjes, actor and founder of Psik, the participants developed short pieces based on personal stories of conflict, discussing everyday encounters between Jews and Arabs.

The movement and dance workshop was hosted by the Vertigo dance group at the Gerard Behar Blaustein Civic Center, and was led by Ilanit Tadmor, a professional dancer and teacher of improvisation and composition. Donald Byrd, Tony Award nominee and Bessie Award winner, participated in the conference as part of his research project at the Foundation for Jewish Culture, in which he is studying the role of the performing arts in the Palestinian-Israeli conflict.

As part of the Conference, two concerts were open to the public. The first took place at Beit Masia and featured the Jewish performers Achinoam Nini and Gili Dor together with Arab dancer Mona Mashi’l. The conference closed with a performance by well-known Arab singer Amal Murkus to an audience of 500 a new record for closing concert attendance.

Here is a link to a short film taken at the rehearsal for the concert.

We are especially proud of the ongoing activities that have sprouted as a result of Speaking Art. The first is the Jewish - Arab theater group that meets at the Jerusalem International YMCA, Freeze, which was started by Speaking Art ‘graduates’ in 2009. Also of special mention is a core of some 6 musicians who continued to meet in both Tel Aviv and Jerusalem after the 2010 conference. Instances of additional cooperative work that have resulted from this past Speaking Art conference include:

1. Achinoam Nini and Mona Mashi’l are exploring possibilities of working together further.
2. The director of the Jewish - Arab Center in Jaffa is seeking to work with the music group that formed at Speaking Art.
3. The Jewish-Arab music ensemble, Na’am, is seeking to add musicians from the music group to its ranks.
4. The Jewish and Arab facilitators of the theater group, Shmulik Hadjes and Hisham Suleiman, have met to discuss further work together as well.

Some of our participants’ feedbacks:

“It was the best Speaking Art conference yet”

“Thank you for creating this conference, which provides an excellent platform for acquaintance and mutual activity! May we continue having dialogue and making art in the coming years!!!”

“Many thanks to you at the Jerusalem Intercultural Center and your partners: Dear Foundation, the Jerusalem Foundation and the Jerusalem International YMCA for holding this conference. For Jews and Arabs who wish to listen and cooperate it was a blissful event”.

“This time the event was so much emotional for me that I found myself crying while watching some of the acts. The workshop with Samir was fantastic and the live performances were phenomenal! The standard of the conference this year was highest than ever. Bless you!”

“I want to express my appreciation to the center’s staff. The big effort put into the conference is very evident. Well done!”

Report on Speaking Arts 2011 at the Jerusalem Foundation Website

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. This article was even translated to German - see here!

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

1. 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.
2. 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.

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

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.

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.