Who We Are

1. Health Care and Cultural Understanding within the Arab, Middle Eastern, Muslim and South Asian Communities

2. Who We Are • The Arab-American Family Support Centeris a non-profit organization that empowers new immigrants with the tools they need to successfully acclimate to the world around them and become active participants in their communities.

3. Welcome /Goal Participate in a conversation about culture, trauma and their impact on health—how caring professionals’ identities impact their work Approach: Cultural humility framework to better engage one another

4. Do No Harm! • Discussion can be challenging and identities are personal – respect each other and practice self-care • Some materials might be sensitive and triggering, so practice self-care • Not all identities are visible and many are more complex than you may think – avoid assumptions • Always feel free to pass, if you are not comfortable sharing • Allow for different voices

5. Identity • The Process • The Evolution • Worldview • Belonging

6. What is Culture A critical definition of culture refers to shared experiences or commonalities that have developed and continue to evolvein relation to changing social and political contexts. (Source: Sujata Warrier)

7. Based on: • Race • Ethnicity • National Origin • Religion • Gender, Gender Identity • Age • Class • Language • Disability Status • Immigration Status • Education • Geographic location (space) • Rural Urban • Time • Historical Context of oppression, occupation, colonialism, and war

8. Let’s Practice • What contributes to my cultural identity? Perceived Evolved and Acquired Personal sense of cultural identity

9. Let’s Practice • Common assumptions about me? • https://www.youtube.com/watch?v=XUO59Emi3eo

10. Let’s Practice

11. Let’s Practice

12. Let’s Practice

13. Culture and Trauma • Culture is related directly to experiences of trauma and the journey of resilience. • Culture also shapes an individual’s: • Ability to access help and support services. • Assumptions about the role of the health system.

14. Cultural Humility Walk the talk of cultural humility: The ability to understand and communicate effectively with people across different, intersectional cultural groups.

15. Cultural Humility Knowledge Attitude Awareness https://www.youtube.com/watch?v=Dx4Ia-jatNQ

16. When working with patients • When working with patients it is vital to consider and connect his/her/their experiences and values to: • Family • Community • Social support • Social networks • Structural experiences • Messages

17. When working with patients Place of Worship Professional Affiliation Home Work Patients S.S. org Friends Healthcare provider School

18. When working with patients- continued • When working with patients, it is important to consider individuals on many different levels: • Understand the relationship between the psychological and social dynamics of a person (psychosocial). • Seeindividuals as complex, dynamic beings, with capacity for innovation and resilience. • Avoid generalization

19. Some Background • Arab does not equal Muslim • Arabs are also: Christian, Druze, and Jews …. • Pew Research Center estimates that Muslims made up about 1% of the total U.S. population (about 322 million people in 2015), and estimates that the number will double by 2050. (Pew Research Center) • Over half of the projected growth of the American Muslim population from 2010 to 2015 is due to immigration. (Pew Research Center)

20. Cultural “Norms”/Challenges Cultural regional “Norms”/Challenges for the AMEMSA communities: Food and other substance are believed to play a role in health and wealth

21. Cultural “Norms”/Challenges Other causes of illness is associated with exposure to cold, sudden fear, emotional upset

22. Cultural “Norms”/Challenges The common believe that whatever happens it is accordance with God’s plan

23. Cultural “Norms”/Challenges Fear of seeking help from psychiatrists because of the stigma associated with mental illness

24. Cultural “Norms”/Challenges Preventive care is usually not practiced ( sometimes, people complain that the doctor didn’t do enough to help)

25. Cultural “Norms”/Challenges Family members accompanying patients to the hospital

26. Obstacles for Immigrants • Language Barriers • Immigration Status • Trust in the health system • Not having the support network needed (Isolation) • Cultural misconceptions

27. Modesty in Islam • Rules of modesty are for both men and women • Modesty between genders is a critical guideline that impacts dress, verbal, and nonverbal communication. • “Hijab” refers to scarf that covers a woman’s hair (not all Muslim women wear the Hijab). • Some women may also cover their faces with a veil called “ Niqb,” or wear an outer robe over their clothing called “Abaya.”

28. Modesty in Islam- Continued • It is important to note that dress varies greatly across cultures and individuals. • Many Muslim women don’t cover their hair and covering the hair is not an indicator of one’s religiosity. • Many Muslims follow dietary rules in their consumption of meat and alcohol. Pork and alcohol are not permitted, and meat must be halal.

29. Things to Consider • Consider prayer time, fasting and religious holidays when making appointments. (Muslim Holidays: EidulFitr and EidulAdha are the two main holidays in Islam. Muslims fast during the month of Ramadan, from dawn until sunset. EidulFitr is a celebration to mark the end of the month. • For some people from the region, it is impolite sometimes to directly say no. • Eye contact • Hand shake

30. What can we do? • Ask simplified questions • Be tolerant of non-responsiveness • Avoid medical terms when possible or if necessary use plain language • Allow for silence before answering • Meet the patient where they are at, and allow them to educate you about their cultural identify • Be transparent

31. Thank you!