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Faith and Health Partnerships

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1 Faith and Health Partnerships
Lowell Community Health Center Trairatanaram Temple, Glory Temple, Kirivongsabopharam Temple, Watmixyaram (Lao) Temple

2                    Overview Lowell: Population-105,000, 2nd largest Cambodian population in U.S. at 25,000 Lowell Community Health Center: serves 22,000 people annually with medical care, behavioral health care, and public health promotion; 22% Asian Metta Health Center: Integrates mental, spiritual, and physical health services through Southeast Asian and western treatment

3 Metta Health Center Metta = loving kindness in Pali, Buddhist language
Staff: Primarily Southeast Asian and others with experience in Southeast Asia Services: Primary care for all ages, lab, mental health services, acupuncture, massage therapy, meditation, consulting Buddhist monk and Kru Khmer

4 The Cambodian Experience
: War, social disruptions; movement from countryside to cities : Pol Pot Period 1979: Vietnamese invasion Refugees flee to Thai border Resettlement in U.S.

5 Partnership Examples Health Screenings Nutrition Learning
Health Education Health Screenings

6 Elements of LCHC – Buddhist Temple Partnership 1. Metta
Health screenings (diabetes) Flu shots New Years Outreach (New Years is in April) Meet together regularly Monk is official consultant, name tag, welcome to mental health team Monk gave the name for Metta Health Center = loving kindness, one of the four basic approaches of Buddhism Monk participated in planning the Center Mental health – taking people to the temple, recommending ceremonies, depending on patient’s particular problem

7 Public Health & Faith Institute, Emory University
Monks use MHC services – from 4 temples, feel comfortable coming because understand, speak same language, Khmer NP (not Buddhist) Monks refer people to the MHC: Patient who said monk told him to go to “our health center” – good sign of “ownership” Blessing of site (also Protestant minister) New Year’s celebrations at the health center with blessings from monk Meditation Center

8 2. CCH 2010 Health Fairs/Booth at New Years Meditation
Health education sessions at the temple on diabetes, CVD, nutrition, including special night in lunar calendar Elders’ Council Remembrance Day for 9/11, Khmer Rouge victims with monks chanting and diabetes, blood pressure screening Community behavioral risk factor survey Learning tours with monks in attendance Bo Jom Roeun Ayu – Ceremony encouraging children’s attention to their parents’ health

9 CCH 2010 Community Survey Random sample of 500, adults 25 and older, interviews in homes 99% born in Cambodia 87% Buddhist, 10% over 50 meditate 28% get health information from temple/church 96% always speak Khmer at home 73% used traditional treatments

10 3. Cambodian Health Service Improvement Program/Reaksmey Sangkhim
Patients go to temple for detox and recovery Patients go to temple for teaching and then help clean up or cook to give community service Monk at AIDS Walk, spoke Field trip to Kirivongsabopharam Temple Meditation/stress reduction as part of treatment

11 4. Men of Color Program 5. Tobacco Education
Outreach to men through the temple to make them aware of need for preventive health care, prostate screening 5.      Tobacco Education Temple became smoke free Cambodian weddings no longer give cigarettes as part of reception practice PSA filmed at the temple

12 Role of Buddhist Temples & Religious Leaders in Addressing Health
Especially Relevant Buddhist Teachings That Relate to Health – Preventive Health, Mental Health/Stress (Meditation, Ceremonies) 5 precepts: Don’t lie, kill, steal, commit adultery, drink alcohol Cutting desire leads to less suffering and less anxiety Impermanance of life, get old, get sick, die – can’t avoid it Basic qualities should seek: loving kindness, compassion, equanimity, & sympathetic joy

13 Mental Health and suffer from PTSD.
Many Cambodians are depressed and suffer from PTSD. Severe & moderate mental illness at more than 3X general US population rates. Many are not able to understand what they are suffering from as there are no directly translatable terms in Khmer. Cambodians’ collective traumatic experiences include witnessing war, separation from and death of family members, cultural destruction, torture, and starvation. Many remain isolated and hopeless, unaware that help is available.

14 Health Beliefs Influences: Wind illness - internal conditions
Holistic sense of health and wellness Influences: Wind illness - internal conditions due to lack of balance or harmony Hot-Cold imbalances Environmental forces Working too hard, “thinking too much” Spirits

15 Approaches to Treatment
Understanding cause of illness Treatments Restoring balance Coining (rubbing the wind), Cupping (sucking the wind), Pinching (pinching the wind) Hot-cold balance Addressing spirits Western medicine Injections / Medications

16 Traditional Healing Koh Kyol (Coining) - is used to treat a variety
of ailments, including fever, upper respiratory infection, nausea, weak heart, and malaise. Pinching - is used to treat headache and malaise Uch (known as "moxibustion" in the literature) is used to treat gastro-intestinal and other disorders. Oyt pleung is seldom done in the U.S., but many adults will have four to six 1-2 cm round abdominal scars from the procedure. Traditional and Herbal Medicines – can be bought in Asian stores, such medicines include a wide variety of plants (leaves, bark, extracts) and other substances. (Chinese Medicines) Kruu Khmer healing methods

17 Spiritual Healing Religious articles – amulets, strings,
katha, Buddha images, commonly worn around the neck or waist. Yuan – written in magical Pali, usually hung on doors or folded in pockets. Tattoos - an older means of protection against harm or illness Not originally buddhist Most Khmer are more oriented to illness than prevention of illness.

18 Buddhist Explanations for Disease/Illness
Has to do with faith, e.g., family problems are their karma, because they did something wrong in previous life and they need to endure that pain. “Trapped” souls cause mental and family problems – ceremonies help to release the soul and cure problems Desire causes problems, suffering

19 Building the Relationship
Different for Khmer and Non-Khmer Must be flexible enough to fit in with monks’ time and availability Long term relationship building Passed from one generation to another Willingness to sit, wait, listen, learn

20 Building the Relationship
Maintain both an inner and outer respect for others Read about Buddhism and its practice Pay attention to what others are doing and how they are reacting to a situation, and be cautious when entering into a situation. Learn about the culture & attempt to implement that knowledge.

21 The Promise and the Challenges of the Relationship
What does one do with a demanding patient who is a monk? Respect the monk and what he says is always right. How can you compensate the temple or the monk when monks can’t take money, no way to get social security number for audit Own sense of time Must eat before noon Transportation – usually don’t drive, not supposed to according to religion Different language used with monks and a lot of younger generation staff don’t know how to speak that way Don’t speak much English and difficult for lay person to translate Often don’t get out of the temple much

22 From Step by Step, Maha Ghosananda
“We Buddhists must find the courage to leave our temples and enter the temples of human experience, temples that are filled with suffering. If we listen to the Buddha, Christ, or Gandhi, we can do nothing else. The refugee camps, the prisons, the ghettos, and the battlefields will then become our temples. We have so much work to do.”

23 Promise & Challenges Because only small number of monks, greatly in demand and have limited time to spend with us Some monks are responsible to other towns/temples, sometimes far away, e.g., South Carolina Different monks have different English levels and levels of information about health care system here and approaches to treatment, e.g., ideas about treating alcoholism – a disease here, not to many Cambodians and especially monks Different resources from Christian, Jewish organizations, e.g., no clothes to give people, but temple can actually provide shelter, a place to stay

24 Impact on Reducing Racial & Ethnic Health Disparities
Promoted trust, healthy behaviors, access to care Decreased isolation – meet with friends, visit Helped people stay sober Helped mental health patients relax and get rid of suffering Empowered elders to lead others

25 Useful Resources Interfaith Health Program of Emory University: MN Web Site:

26 Lowell Community Health Center Contact Information Sonith Peou, Director of Metta Health Center: Sidney Liang, Director of Cambodian Community Health 2010: Bunrith Sath, Coordinator, Reaksmey Sangkhim: Dorcas Grigg-Saito, Executive Director, LCHC:

27 Thank You Sidney Liang, Project Director of Cambodian Community
Health 2010, created many of the slides used in this presentation.

28


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