CULTURAL COMPETENCY

1. CULTURAL COMPETENCY Presented by Abdul Bakar Jewish Vocational Service

2. Jewish Vocational Service • History: established in 1949 to resettle Holocaust survivors and other refugees • MISSION: to assist any individual with barriers to become more self-reliant by providing employment, training, personal development, and support services.

3. Jewish Vocational Service • Refugee/Immigration/Lang. & Cult.Svcs. Dept.includes refugee employment services, refugee resettlement, immigration counseling • Language and Cultural Services Dept. includes Interpreter Development Services, Cultural Competency training, Occupational Spanish classes, Title VI training, Provider training

4. Setting the Tone • Expectations • Training Goals • Ground Rules • Introductions

5. Trainer Expectations • Show respect by listening to each other and not interrupting. • Participateactively in the training. • Maintain strict confidentiality by not identifying specific individuals or clinics or anything else that could identify a client or provider and not sharing outside the classroom any of the personal stories that are told. • Give feedback in appropriate ways by starting feedback with a positive comment; avoid blaming; identify individual opinions as such.

6. Training Goals • Increase awareness of diversity • Expand definition of cultural competency • Improve service quality for diverse populations • Work more effectively with interpreters • Understand Title VI and Basic Components of Office for Civil Rights policy guidance • Improve cross-cultural communication and decrease potential misunderstandings

7. Your Goals • What do you hope to learn from this training?

8. Icebreaker • Your name and what you do in your organization. • Who is your community?

9. Refugees / Immigrants: Frequently Asked Questions • What is the difference between refugees and immigrants? • Refugees have fled their country because of a “well founded fear” of persecution, while immigrants have left their home country on their own will.

10. Refugees / Immigrants: Frequently Asked Questions • Why do refugees leave their country? • There are many reasons, some main ones being: war, religious or political persecution, reasons of race, etc. • Why do refugees come to the U.S.? • Refugees do not choose where they go from the refugee camp; they are assigned by the UN. • Do refugees ever return home? • Yes, in large numbers, although many others also choose to stay and build a life where they are assigned.

11. Refugees / Immigrants: Frequently Asked Questions • Why do immigrants leave their country? • Again, there are many reasons. It may be to find a better job, to reacquaint with family, to build a better life, to gain an education, to simply live in another place, among many other reasons. • Do immigrants help or hurt the United States? • Immigrants have contributed greatly to the face of the U.S. in the types of food we eat, the music we hear and the many events that take place. They also add to our country intellectually, financially and culturally.

12. Somali - General • High respect for strength and often challenge others to test their limits • Justice is based on the notion of "an eye for an eye" • Somalis are a proud people • Deep value on the family. The strength of family ties provides a safety net in times of need, and the protection of family honor is important. • Loyalty is an important value and can extend beyond family and clan. Somalis value their friendships

13. Somali - General • High value placed on independence, democracy, individualism and generosity • Somalis generally do not express their appreciation verbally. • Strong adherence to Islam • While Islam and the Somali language unite all of Somalia, the societal structure is markedly fractionated by membership in patrilineal clans • Much of the current strife in Somalia is centered around clan disputes, as allegiance to the clan far outweighs allegiance to a united Somalia

14. Somali - General • Handshakes are appropriate only between men or between women • The right hand is considered clean, and is used for eating, handshaking, and the like; children are taught early to use only their left hand for hygiene during toilet training • Ritual cleaning of the body, especially before prayers, is dictated by Islam • Birthdays are not particularly celebrated by Somalis, and it is not uncommon for people to not know the exact date of their birth

15. Somali - Gender Roles • Strict separation of the sexes, and women, including sometimes prepubescent girls, are expected to cover their bodies • However, women in Somali culture have considerable status, and many resettled refugee women are highly educated and held professional positions inside Somalia

16. Somali - Traditional Medical Practices • Herbalists, bone-setters and religious practitioners are traditional medical practitioners • Herbal medicines are widely used in Somalia, especially for chest and abdominal symptoms • ”Fire-burning" is a common practice where a special stick is burned and then applied to the skin

17. Somali - Traditional Medical Practices • Concepts involving spirits, such as "evil-eye," where excessive praise or attention can attract evil spirits to a infant or child, can be viewed as causing illness • Ritualized dancing is used mostly for psychosomatic disorders, and Koranic cures as well • Female genital cutting is commonly practiced

18. Somali Bantu - General • The Bantu are an oppressed group within Somalia • Known for a strong work ethic • Capacity to easily adjust to any situation • A resourceful people with many different skills • Strictly follow Islamic ideals • Because the Bantu stand outside of Somalia’s dominant clan rivalries, they won’t participate in the clan violence sometimes seen in America’s immigrant Somali communities

19. Somali Bantu - General • very strong sense of family and community • limited exposure to urban ways of life, such as transportation systems, rental property, and government services • Electricity, flush toilets, telephones, and kitchen and laundry appliances are all foreign concepts to most

20. Somali Bantu - Gender Roles • Generally Bantu society is a patriarchal one in which the father is the main provider and the mother is the general manager of the family's domestic affairs • Daily life for most men is consumed by either working on private farms or at wage earning jobs. Most women play the role of the head of the household, while also being responsible for food preparation and farming tasks.

21. Somali Bantu - Health Care Practices • The Bantu are a rural people who practice traditional beliefs. • Some Bantu apply a heated nail or metal object to an infant's head in the belief that the burns will reduce the swelling of the head in cases where it is unusually large. • They also burn small holes in the skin to cure ailments like stomach aches and migraine headaches. • Like other rural east African people, the use of herbs in traditional medical practices is common.

22. Somali Bantu - Health Care Practices • Religious prayer is used to help ward off or cure illness and disease • Traditional healers also play an important role in performing ritual ceremonies, known as Gitimiri or Audara, to cast off illness and evil spells • Like other Somali groups, the Bantu circumcise both males and females. The female circumcision practiced by some Bantu is a milder form than that practiced by the other Somali groups

23. Somali Bantu - Health Issues • A long history of marginalization has adversely affected their sense of equality and self-esteem. • The Bantu were further affected by the recent civil war with many fleeing only after their villages were attacked. • There is not only the aftereffects of trauma from violence and the constant threat of attacks in the refugee camps, but also the Bantu's intergenerational culture of inferiority and second-class status.

24. Working Effectively with Interpreters • Who is an appropriate interpreter? • Roles and responsibilities of interpreter • Effective strategies for communicating through an interpreter

25. Who is appropriate to act as an Interpreter? • Bilingual staff who are trained and competent in skill of interpreting • Staff interpreters • Contracted Interpreter Service • Community Volunteer Interpreters • Telephone Interpreter Lines

26. Who is NOT appropriate as an Interpreter? • Friends of any LEP individual • Family member of LEP patient/client • Minor children • Anyone who has not demonstrated proficiency in both languages • Anyone who has not received training in interpretation • Anyone who does not have an understanding of ethics and interpreting practices

27. Interpreter • The basic purpose of the medical/social service interpreter is to facilitate understanding and communication between two or more people who are speaking different languages. • CCHCP, Interpreter training curriculum

28. Roles of the Interpreter • CONDUIT • Interpret exactly what is said: add nothing, change nothing, omit nothing. • CLARIFIER • Adjust register or complexity of language. Check for understanding. • CULTURE BROKER • When cultural differences cause misunderstanding, provide necessary cultural framework for understanding message. • ADVOCATE • Action taken on behalf of someone else.

29. Tips for Effective Communication through an Interpreter • POSITIONING – interpreter should be seated next to and a little bit behind LEP client • ACCURACY – everything that is said should be interpreted; no side conversations; check for comprehension; speak in short phrases and pause to allow for interpretation • COMPETENCY – assess interpreter qualifications and skills; bilingual individuals should be trained in interpreting and have knowledge of policies at your organization

30. Medical errors • According to a study by the Institute of Medicine, “at least 44,000 people and perhaps as many as 98,000 people die in hospitals each year as a result of medical errors that could have been prevented.” • Source: Institute of Medicine, “To Err is Human: Building a Safer Health System”, Nov. 1999

31. Language and Culture • “People who speak different languages live in different worlds, not the same world with different labels.” • Edward Sapir, linguist, 1928.

32. Contact us! Jewish Vocational Service Language and Cultural Services 1608 Baltimore Kansas City, MO 64108 (816) 471 - 2808 www.jvskc.org Brandi Miller bmiller@jvskc.org Cathy Anderson canders@jvskc.org