The 130th Annual Meeting of APHA

Abstract #51530

Ruth Lyn Riedel, PhD, Alliance Healthcare Foundation, 9325 Sky Park Court, Suite 350, San Diego, CA 92123, 858/614-4888, rriedel@alliancehf.org

Built on the success of the prior African Collaborative Health Initiative which addressed female circumcision, five African community-based organizations (CBOs) expanded the original scope of work to include prenatal care, well baby and child care and breast cancer. The target African community included immigrants and refugees from seven countries. In the first year, all health educators received training in how to do outreach and how to work with women’s health issues such as the health problems related to female circumcision. Trainers were retained to provide assistance to health educators as they offered individual and group education and referrals to health providers. In addition, health educators translated educational materials into native languages and provided translation services as required. Educators held 27 community workshops for 883 people and reached 589 residents individually. The collaborative itself organized a training workshop for health care providers and taught classes on cultural training to medical students at the University of California San Diego School of Medicine.

Internal challenges included the patriarchal bent of these East African cultural groups, extreme distrust and dissension within and among the CBOs, and the absence of financial management. CBO training, capacity building and restructuring were critical components of the project. External challenges included the widespread fear of prosecution, prejudgement of cultural practices and the lack of cultural competency in San Diego’s health care system.

To be successful in supporting a community-based refugee and immigrant population, it is important to identify existing assets and provide the necessary “technical” tools and skills as requested. And, of course, it is essential for the target community to address health and organizational problems from their own cultural perspectives and to design their own appropriate interventions.

Learning Objectives:

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• Recognize the delicate balance between offering assistance to enable change respectfully and forcing target immigrant groups and CBOs to accept “help.”
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• Identify the societal and political realities of African refugees and immigrant communities and recognize the need to work with them--not against them.
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• Understand the cultural significance of female circumcision in some African communities, related health problems and the impacts on health care providers.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.