The Jerusalem Inter-Cultural Center Blog

After the workshops at the Clalit primary care clinics at Ir Ganim and Talpiot, we continued this week with two half-day trainings for the staff of the Gonenim clinic, conducted at the JICC premises on Mount ZIon. These three clinics serve most of the Ethiopian Jewish immigrant population in Jerusalem, and we adapted our cultural competence training to focus on the needs of this group. All clinic staff members, from physicians to administrative staff, attended the workshop, as we see the response to diversity at the clinic as an integrative task.

Gonenim Clinic Training 2009

The workshop was in general very similar to the ones we conducted before. However, we used many more examples, which participants in the previous workshops raised, and based the training on case studies and simulations. This made the training closely related to the practical issues brought up by clinic staff members.

Gonenim Clinic Training 2009 - roleplaying

Following this training the Gonenim clinic now joins the support system we are creating to enhance the Clalit Health Services’ capacity in providing better and more adapted services to new immigrants. We will conduct follow-up meetings with the clinic’s management and mentor them in implementing Cultural Competence in the clinic.

Gonenim Clinic Training 2009 - roleplaying

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

Talpiot Clinic Training 2009

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

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

Michal Schuster at the Second workshop in Ir Ganim Clalit clinic

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

Using a cultural liaison in a simulation

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

A nurse participating in a simulated case

Following previous meetings on adapting Clalit’s clinics to Ethiopian patients, the representatives of Clalit and the JICC discussed today the detailed plan for cultural competence in serving the Ethiopian community in Jerusalem. The meeting was very fruitful, and based on many insights, a detailed workplan is currently being formulated. First training will be held in February in the Ir Ganim neighborhood, followed by similar two-days trainings in all relevant clinics. In parallel, signage and other adaptations to this community will be applied.

At the meeting we’ve received an update that according to schedule all the relevant clinics are now fully equipped to provide the “Tene Briut” tele-interpretation services in Amharic. It is important to emphasize that unfortunately, up to this point, this is the only tele-interpretation service existing in Israel in any language!. It is our hope to find the means to create tele-interpretation services in additional languages, such as Arabic and Russian.

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

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

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

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

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

Following a steering committee meeting on adapting Clalit’s clinics to Ethiopian patients, a meeting was held between the head of the Clalit committee and the JICC to define the main components of the cultural competence in health program in the city, as well as first steps. Clalit is the main HMO serving Jerusalem’s residents. One of the first steps decided upon was to ensure that the Amharic teleinterpretation service of “Tene Briut” would be expanded to all Clalit’s clinics in Jerusalem. The JICC introduced this service in Jerusalem, and the Clalit’s Talpiot clinic, serving around 500 Ethiopian patients, was the first to adopt it. Today, we were informed that permission was granted by Clalit to incorporate the service in the other three relevant clinics in Jerusalemite as well as in four suburban clinics that serve the Ethiopian community. The teleinterpretation service provides a major improvement in health care for this community, which suffers greatly from language and cultural barriers.