Jerusalem's Alyn Hospital for the rehabilitation of physically disabled children will be the first medical center in the country to formally launch a program to promote the "cultural competency" of its staff so patients of different languages, ethnic groups and beliefs can understand and be understood by doctors and nurses.
Promoting cultural competency in medical and other institutions has become a major issue in the US and other countries with a wide variety of racial, religious and ethnic groups, but even though Israel is a nation of immigrants, it is way behind. The inability of many patients and hospital staffers to understand each other not only causes embarrassment and degradation, but can also cost lives, as when patients swallow medication meant to be applied to the skin or when doctors are unable to figure out their medical histories.
A pioneering conference on cultural competency in hospitals was held Wednesday at Alyn, with speakers from Coney Island Hospital in New York. This 448-bed public hospital in southern Brooklyn - which caters to dozens of ethnic groups, from Russian Jews to immigrants from Croatia, China, Japan, Korea, Mexico and Pakistan - is a US leader in training its staff to communicate with patients who have different languages, concepts and cultures than the average US-born Caucasian American.
Hospital director Dr. Shirley Meyer said that in this part of the Middle East, cultural gaps are also a political issue, as "the political situation colors our lives. There is suspicion, anger and fear." She added that doctors should be aware, for example, that having a limb amputated to save one's life is regarded by Muslims as worse than death, and this must be taken into account.
Prof. Leon Epstein, a veteran expert in public health and fighting inequities in health care, said that while, for example, there are sporadic programs in various hospitals to lower the high rate of diabetes among Ethiopian immigrants (which was unknown in Ethiopia and presented itself only in Israel), these are not enough. There must be a national health policy to educate people of other cultures and eliminate the inequity in life expectancy, infant mortality, accidents, morbidity rates and dangerous health behaviors in specific groups whose socioeconomic and education levels are low, he said.
He noted that new immigrants who barely speak Hebrew are asked to sign hospital consent forms that even veteran Hebrew speakers cannot understand. Only a handful of hospitals have medical interpreter services; however, a voluntary project called Tene Briut, which began as a one-time effort to save an Ethiopian girl whose life was endangered by type I diabetes, is offering well-trained interpreters with medical knowledge.
Coney Island Hospital's associate executive director, Brian Palmer, told the 100 participants that the hospital posts signs in a wide variety of languages, from Yiddish to Urdu, and apparently has the world's only hospital interpreter in Russian sign language. It also routinely offers translation for patients; has built prayer rooms for Jewish, Muslim, Christian and other religious groups; provides kosher and halal meals for religious Jews and Muslims; and supplies male or female doctors and nurses if patients ask for someone of the same gender.
Young Lee, the Brooklyn hospital's director of training and development, who arrived in the US from Korea with his parents at age nine and served as their interpreter, said giving recognition, rather than extra payment, to employees who excel in cultural competence was an effective incentive to improve their performance and minimize insults, confusion and medical errors.
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