1. Somali Central Minnesota Somali population & Health Care

2. Somali Case Story by Linda Meehl Clinical Research Specialist Coborn Cancer Center CentraCare Plaza

3. Case Story # 1 An Emergency Department Experience

4. Summary 54 year old Somali Woman taken to the emergency room after falling at a local park

5. Background She has been in the USA for 3 years Upon arriving in the US stayed with a host family

6. Background Continued Her husband was killed in front of her She knows common English terms and can in normal circumstances communicate her needs to others through the English she does know and modified sign language. Her children are usually interpreters for her when needed

7. Background Continued She has four remaining children, all are currently in the US with her One daughter & three sons Her children are well educated and three have completed high school and began a college education They understand and enjoy the US healthcare and education system

8. The Event She was brought to the ER alone by two male paramedics They stated that the patient refused to communicate with them in any way The patient once at the hospital was assigned two male ER staff (One male physician and one male aide)

9. The End Result Patient was upset over “cultural blunders” on behalf of the health care staff Patient was upset over “cultural blunders” on behalf of the health care staff Patient left without being treated for her illness or injury Patient left without being treated for her illness or injury It was never discovered what happened with the patient that day It was never discovered what happened with the patient that day

10. Health care professionals not understanding the Somali Muslims religion / culture Assigning all male health care professionals Not having an interpreter available- using the interpreter phone Touching or shake the hand of a person from the opposite sex when greeting

11. Health care professionals not understanding the Somali Muslims religion / culture Health care professionals not having a basic knowledge of the Somali culture Having at least one female member of the health care team available for women being treated due to their cultural and religious beliefs If patients husband or male

12. Language & Communication Not having Somali interpreters available, many felt using the interpreter phone was degrading and interpretation was not always accurate Many felt their voice was not heard, the health care professional decided what was best for the patient regardless of their cultural and religious beliefs

13. Solutions: Have all health care professionals attend cultural competency training Basic working understanding of other cultures necessary to do the job accurately and safely for all involved

14. Solution Continued When a patient is admitted cultural preferences, such as female care staff only and no pork, are automatically printed in bold format on the patients chart A half sheet with general information regarding the patients culture is printed to place on the patients chart for quick and easy reference.