Episode 8: A New Philosophy of Better Health

What barriers to health might be in place for recent immigrants and how do we put people on a path to better health? At its core, this is a story of culture, understanding the whole person and their unique individual stories — things our health system is just not designed to do. Kurt talks with Mona Antilla Carloni and Mariam Mohamed, the creators of Intercultural Alliance, a program tailored to the health needs of Somali women and taught through community, food, and personal experiences. Mariam, a Somali immigrant herself, has worked in program analysis and evaluation for private and non-profit services. Mona comes from the creative design and marketing world, with a passion for wellness design and holistic health coaching. Learn how they work together to improve health disparities in Somali communities, one person at a time.

Kurt

Mariam, Mona, thank you for joining me today. I’d love to hear a little bit more about your backgrounds and what you’ve been working on.

Mona 

Hi there. This is Mona. Yes, my name is Mona Antilla Carloni. And I’ve been working in the healthcare field, it feels like a long, long, long time, in various capacities, but over 35+ years. Doing this work of late, I have really moved my whole focus into how can we better serve our communities in their health and wellbeing in terms of avoiding such serious illnesses as heart disease, diabetes, obesity, mental illness? How do we address these issues in a different way? And so, my world has all been sort of looking at how we can better address those issues in a non-medical way to support our communities. So, they can really come to the table as full and complete and whole and not be pulled down by their health by any other issues that they may be dealing with. And so, I’ve kind of let go of my earlier career in marketing and design communications. And so, this is where my heart is in really making a difference in our communities. And how do we sort of bridge the gap so that our communities are really getting the attention they need to fulfill who they are on this planet? And it comes down to me as finding our health.

Kurt 

Mariam, how did you and Mona meet?

Mariam 

Okay, Mona and I met 2002. I moved from — let me backtrack. I came to Minnesota in 2000. I was visiting my family who were refugees, came here as refugees. And at the time, I was living in Dubai, I moved from upstate New York to Dubai to be with my late husband who founded a telecom company that was helping ethnic Somalis in the Somali community to come together on business basis, because they were fighting over clan basis. So, I visited my family, and my husband ended up being the Prime Minister. And then I ended up being stuck for two years, I was there, and I moved here to Shoreview, Minnesota in 2002. And I was asked by the Somali community to develop a Somali Parent Teacher Association. And I asked around who can be a good grant writer and Mona’s husband was the man I met. So, this was 2002. And she happens to live in North Oaks. I live in Shoreview, we have five, six minutes’ drive from each other. And I loved Mona from the start. I had health issues, I have Crohn’s. And I will go to the emergency sometimes when I have issues, and Mona fixed that for me, and I loved how she fixed and I introduced it more to my colleagues and UCare. And so, this is where we are today, I come from philanthropy background. That’s how I met your beautiful wife. I used to be a program officer. But then when I left that job, I joined to be a consultant for UCare since 2012. I was there. And I introduced Mona’s program to UCare. And so far, they’ve been funding it, I think for the last four years. And here we are. That’s how I met her.

Kurt 

And tell me more about the program, the Intercultural Alliance, how did that come to be? And what is it?

Mona 

So Intercultural Alliance is really about bridging the gap between community health and the healthcare system. That’s kind of what it grew out of. But it really started with when Mariam and I started talking about these issues, and how do we serve our communities better. I’ve been doing this work for a long time, not in Somali community, but when Mariam and I and our friendship continued to grow, we realized how important it was to address those individuals that were falling through the cracks. So Intercultural Alliance kind of came together and was founded on the basis of how do we address health and wellness in various areas. It was business, it was health, it was community. So those three building blocks, and our focus in our programming has been in the health area, and how do we really empower and support our women in the Somali community. And again, this is only our first entry in, you know, using this program with Somali women. But it’s really a program that is good, it’s adaptable to any culture. But we learned is that there’s a gap, and we can talk a little bit more about that in terms of the studies and it’s all out there. We just did the research brought the studies and the information to the table and went, we need to address this and create a program that does address it.

Mariam 

And to add to what Mona said, as I became a consultant for UCare, I joined their group that’s now called equity. It used to be a disparity group. And one of the key things, you know, as you know, UCare has to have some quality rating, they have to have programs that they have to fulfill to the federal government, as well as the state, to kind of say, this is what we do it for, for them to be accredited. So, one of the key things they were struggling with, they will send surveys out, and especially to different minority communities. And they said, we love UCare, everything is perfect, everything is excellent, then you can get all the surveys answered. But the reality is when they the check the numbers, in terms of how these communities are doing, it’s always low. So, they were struggling with that. And I’m the one who said, you know, knowing Mona and her program, and knowing the research that’s out there, I think there are a couple of them that Mona can mention that the MDH at the time, 2007, was putting out on the disparity, how serious it was. Can you mention those two?

Mona 

Yeah, well, there was a study, closing the gap, applying global lessons towards sustainable community health models in the US. And it says the solution to this problem of that gap is the development of a care model capable of bridging the gap between clinical and community settings. You know, the lightbulb went off for us realizing that it’s not just about getting individuals to the doctor, which is hard enough. It’s having people take responsibility for their health, and empowering them to do that, inspiring them to do that for themselves and their families in a way that’s culturally appropriate and sensitive and transfers information that gives them what they need to make the right decisions or better decisions about their own health. We learned that lack of access to culturally competent healthcare is one of the most significant barriers to reducing health disparities for minority populations. And this is actually from a study from Betancourt and Green from 2007. This is not a new issue. Failure to understand and manage socio-cultural differences may have significant health consequences for minority groups. So, there’s many, many studies and I actually, I can always email that information to you because they’re all there to support the work, which this is all based on these studies and more

Mariam 

I shared those with UCare. Actually, I share those with Ghita [Worcester], I share those with the committee that Greg [Hanley] is part of, and I think everybody was looking for solutions. And I came up with saying, you know, I have a friend who is really amazingly helping me with my Crohn’s. I was very sick, I was taking medications at the time I left the McKnight Foundation, I didn’t have health care. And so, I had to pay $1,700 for me to have insurance because Crohn’s was a pre-existing condition. And so, she came along and, since 2012, now I’m not on medications. And all I did was change the lifestyle with the help of Mona, the program. She kind of put it together. And so, I told my story to UCare and to the committee and specifically to Ghita, who’s a dear friend of mine. And I said Ghita, let’s think of this and she really liked the idea. And so, we didn’t wait for them. You know, as you may know, you can introduce ideas and things, but it takes time for funders to really do it. So, I have a good friend who, at the time, was a director of the George Family Foundation, and I called her and I said you know, I have this idea, can we try and she gave us the seed money. And so, we partnered, we actually started with my family. I have sisters who are overweight, who are struggling with diabetes, struggling with, you know, low vitamin D, lack of sleep. And so, I say to Mona, let’s just start with 10 women and you know, my family and their daughters who are also married, and that’s what we did. And we created this video that Monique mentions to you all the time. And it was eye-opening, where my sister who was prediabetic now no longer takes medications. My sister who had struggled with vitamin D, and I will go with her to the doctor, and she will give all these high doses of vitamin D, and then Mona introduced us to all this, you know, ways to increase her vitamin D. And she went back, and she said, what did you do? And so really, we saw firsthand with my family. And finally, when I show some results to UCare, they then said, let’s adopt this program and start funding.

Mona 

And I think it’s important to understand it’s not simply seeing, okay, Mariam, you’re having an issue with Crohn’s, or your sister. It’s the how, and it’s the process. So instead of saying, okay, let’s give you a whole lot of information on what happens with a pre-diabetic state, and what you need to do in teaching about all of that, or you need to lose weight in order to do this, this and this. Instead, we build relationships, there was a lot of trust over the time, and it wasn’t about getting all the information in quickly, it was about developing relationships. And so, the program is really built on around building trust as the foundation of it all. And so, we come together, we have tea, we have dates and almonds, we share, you know, just our stories together, we take time and the learning, there is always learning, but it’s through our discussion, stories, cooking together. And it’s not just tapped down, you need to learn what diabetes is, but rather, how are you living your lives? And how can we shift and add some things in that might shift how you’re doing, what you’re doing. So, there’s ways where the culture really comes in. And we were very attentive to that. It’s not just about, here was what you need to do about Crohn’s. But over time, building relationships.

Mariam 

Does that answer your question? Or you need more?

Kurt 

Yeah, no, I think you’ve hit on a really key component. And I’ll just mention that UCare is a health insurance company in Minnesota that deals with Medicaid and Medicare members and serves a large segment of the Somali community, immigrants to Minnesota. And so, what you’ve hit on it sounds like is a way to provide culturally sensitive training around lifestyle and behavior that also recognizes what we now call social determinants of health and the barriers that are preventing people from leading their healthiest lives. So maybe say a little bit more about what is the structure of that culture training? What does it look like when you get these women together?

Mona 

Pre-COVID, we would have women come together in a community setting, let’s say a community room that had access to video and a kitchen. So, we would come in early, and we would create an environment that was beautiful. And this is important pieces, even though it may seem extraneous, and not important, there would be flowers, there would be hot Somali tea, there would be dates, and there would be almonds, and that we would put the almonds in the date. So, it would cut the intensity of the sugar and the sweetness. So, you’d have a little bit of protein and fiber. So, here’s where the lessons go in without anyone even knowing. There’d be fresh oranges or mandarins, there would be all the cooking was all set up in the back where the kitchen was, beautifully, you know, all the vegetables and all the things that we would need to cook were all set up. So, the woman would come in, they’d sign in, and they’d start to talk and check in and get to know each other, get to know us in a beautiful environment and in a beautiful space. The first week was all intake and getting to know each other. The second week, come in and check in how was your week, tell us a little bit about what it was like and what your family was dealing with or anything. And so, we would start to build these relationships from there, we would have a theme every week or every time we met. If it was about water and the importance of water or sleep, or what about blood sugar and how sugar affects a person, we would have information and we would be very visual. And I was mentioning to this to you earlier, Kurt, that I am a person that likes to research, and I like to hand out information. Mariam would just laugh at me and go, Mona, no, no, no, no, no, we need to talk it through. We need to look at it. We need to hear stories. And for me, you know, it’s been huge. And I’ve always liked this action, reflection, learning model of let’s just walk in and do it and then we’ll learn, and we’ll get back together, and we’ll do it. We’ll talk about what we learned and what needs to be different and we’ll change it next time. So, we’ve been doing a lot of that over the years. Action, reflection and learning and so no handouts, lots of visuals. And when there’s families, we have the children come up front. So, we see usually sit in somewhat of a circle and the children help with the visuals. So, if it’s holding up cards that have donuts on it and going, this is high glycemic, or is this low glycemic. The kids are learning and going, okay, mom, and they’re pointing to the picture and they know the answer, they’re asking their parents what is that, is that sugar, are you gonna affect your blood sugar or not. And so, we involve their family. And then after we do some of that, and not too much, we go into the kitchen and we start to chop and cook together, all of us together laugh. I’m looking at the recipe, no one else does, because it’s really about what it looks like, okay, it’s a little bit of this, a little bit of that, stir, put in the oven, or cook on top of the stove, and you’re done. But that’s the beauty of what we’ve learned is that it’s the coming together. It’s the laughing. It’s building trust. It’s watching how something is cooked and going, Oh, so instead of all this rice, I can use quinoa. I could even use zucchini pasta. What does that look like? And how do I do that? And what are some substitutes for some of the things I love that tea? Oh my gosh, I drink tea four times a day with two or three cup teaspoons of sugar. What can I do that I don’t lose that because that’s a very important part of my life.

Mariam 

And Mona shows, you know, one teaspoon of sugar, how much, she has sugar cubes. And she will show them and say six cubes. They always say, oh my god, this is how much sugar I take in one cup. And I have five cups during the day. So, you know, I don’t want to interrupt. I think the other thing that Mona kinda did not mention that is so important. In Somali community, Mona comes in, I come in with her, I recruit these ladies. And usually we recruit in a neighborhood so they don’t have to drive. They come down from the high-rise building. So, they come down to the, usually, we get the kitchen, in the high-rise building, so they don’t have to travel which helps. And she starts with chanting of the, you know, the Muslim faith

Mona 

Yes, that’s another really important part.

Mariam 

So, they come in, and they’re looking this woman who’s a white American woman, talking about their own faith and telling them what God says about health and what God is, how does she learn this? How. So, they will ask me questions, they don’t understand. And they said, she’s one of us, how in the world, she can mention the Quran. And so that really kind of sets the whole tone immediately. And they see, this woman knows what God, so if she is this American woman who’s an infidel, and she tells me what God is supposed to tell me, I should take it. So, they really, that sets the whole tone of the whole program.

Mona 

So, the tone is one of honoring the wisdom that lies right there in that human being in front of us. We’re honoring, and we’re being of service. So, when that woman walks to the door, we hand her a cup of tea, we don’t let her go to get her own tea, we hand her the tea, and we hand her a little plate of dates and her mandarin orange or whatever. So, there’s a really a shift in, you know, this is about you. What are your needs? What do you need? What are your questions, we’re here to listen, and share what can support you and your family and living healthier and better lives.

Kurt 

That’s so different than our traditional healthcare system. I mean, I think of, you know, the experiences that people in a traditional community would have are, I go to the doctor, I get a diagnosis of diabetes, the doctor gives me a pamphlet or maybe a link to a video. And it’s all private and secretive. And I go home, and I have to figure it out on my own. And what you’ve done is build a community and a whole different approach to understanding not only disease but sensitivity to those barriers to health like transportation, we’re going to have the event in their buildings so that no one has to drive to the clinic. Bring food to the table so that we share and learn how to prepare food and that just is a wonderful, wonderful story.

Mona 

And a lot of the learning happens in every other moment than when we’re in front.

Mariam 

They think of it as a doctor, so they bring their medications. They bring their medications, they bring their issues to Mona and many times, Mona changed the program and really comes up with dishes based on what she learns from the ladies. She learns from the disease and she says okay, now if that’s the case, let’s cook something like this. And they will learn how to cook that and that’s what they will cook and they said we feel better, I don’t have joint pain, I feel better, I’m off from the medications. The doctor is so surprised, he’s asking me what happened and it’s all about listening. So, we say in these eight days, we are many doctors, we think they bring their medications, and we will say to them, you have this medication is this, ask the doctor this, so they tell us, can you come with us to the doctor, will you come? And will you join me to help our doctor to see what I’m going through? Because there are things the interpreter, the other thing, Kurt, you have to understand. We use interpretive agencies, and most of the interpreting people clearly are not savvy. They don’t know very good English; they don’t know the terminology. There are so many translations are lost in the middle. And so, they say, will you come to my doctor, I don’t trust my interpreter, will you come with me? Because they tell them that they don’t tell what I think that I have, they tell something else. That’s a huge issue in Minnesota, these interpreters are really just know small English. And the doctors cannot tell the difference. And they think these interpreters can know what they’re doing. They can’t. I can give you examples where I went with my mother, and the doctor will give her medications. And I say, Mom, why are we using this medication, or the doctor and her interpreter, told the doctor something that my mom did not even say. So, I have to go with her and say, change this or from now on I will interpret which they don’t allow in the state, you have to sign a paper. Because I think the state legislature pass something where family cannot interpret for a patient. So, we’re really fixing some issues that has been created by interpreters between the interpreters and the doctors.

Mona 

And it’s also important to understand that we are really working hard to bridge between what we do and their primary care. Unfortunately, primary care has become the ER. And so, we’re trying to break that because of the cost issues in the healthcare system. It’s not efficient in any way, shape, or form for them. So, we are trying to be that interface, getting information, and understanding and then encouraging them to go to their doctor to go to their primary care, whoever they’re working with, to talk about these things, if they’ve got questions that will help clarify what those questions are, help them write out the questions and then go back to their doctor. So, we’re continually going okay, now go your health care professional. This is how you can do this. I have a thing called a healthcare check, preventative care checklist. And it has all the little annual checkups, your mammogram, have you seen your ob-gyn for your pap smear? What about well-baby checks and it has all these little boxes of these, just the things we normally would do, but many of these women aren’t doing on a regular basis. So, we’re helping them get on a pathway to using the system more efficiently, understanding how to work in partnership with their doctors.

Kurt 

I love the concept of combining health literacy with cultural literacy to generate the trust. I mean that that’s just an amazing component. You had some insights as to why Somali women use the emergency room that I thought were fascinating that came out of your programs?

Mariam 

Well, a couple of things. Number one, I will use my mom as an example who used to use emergency, not anymore. So, what happens, they feel when they go to the emergency, they get full attention. They said when I go to my primary care, I have this interpreter, the doctor comes in for 10 minutes, he leaves and then I come back nothing has been solved. I still have the pain I have. So, we’re coming from a culture where you know, people go to a doctor and the doctor is supposed to fix what you have. That’s where we’re coming from that culture in Somalia. And so, for my mom, she feels like I have this pain. When I go to the doctor. Why do I have to feel the pain, what is going on? So, for her, she says oh I’m sick, I’m sick, I’m sick and sometimes it’s nervousness of why her pain did not go away. It kind of builds up. And so, she goes to the emergency I get a call from my sister saying mom is at emergency. I go to the emergency; I sit with her and we will be there a couple of hours. And you know they do x-rays, they do, whatever, the other things they do, all the machines, the heart rate they also so they think if they can get that, that is something they are not getting from their primary care. So, to them is I could get complete service. And so, they get that and the doctors who are there will tell them go follow up with your primary care. They never do it. They wait, they feel good. It’s all in their heads. You know my mom is 86 she’s never even takes any medications. She’s very healthy, but everything is in her head, so she feels better because they didn’t find anything after they x-rayed here from top to toe. For the spirits, there’s a fear. So, she feels better while she’s happy, and then she starts having these doubts. And she in her mind does not want to go to a doctor because they cannot give her all these x-rays and all these things they cannot look inside. And so that’s honestly, that’s the bottom line. So, what we do is we help them to understand the danger of that. The danger of not keeping up with your doctor, the danger of also being exposed to these machines very often, what they can cause and the minute I explained to my mom, that it. She stopped using emergency completely. She doesn’t go to the emergency for the last few years. And Kurt, you will be surprised, she never needed it. It was all in their head because of the fear and lack of really saying what they want to the doctor. It’s someone else you don’t know who’s an interpreter. She’s not your cousin, she’s not your daughter who’s going to tell what and then she comes back, and she says they can be the same thing. I’m still sick. So that’s a vicious cycle. I have been talking to UCare about this interpreting business. I know it’s big, but it’s not helpful. It’s very costly. 80-90% of the Somali people who are interpreting are woman. For them, it’s job, they don’t really, how do we find them jobs? How do we also create what we created in early childhood, that the job ladder where this woman who go to interpret, they have a passion, they can be a nurse in the future or an aide in the future. But this is to me, it’s we need to manage that services, the interpreting services, and I have no idea how that will happen. I even talked to Mary Zimmerman when she was the assistant commissioner, I even sat with her to say, Listen, this is really creating more harm than health. And I did a focus group. I did a survey just on my own in the Somali community, and in the Hmong community, about interpreting and you will be surprised to hear to the findings that so many of the people they’re interpreting, do not trust them. So, they come to us. And that’s why they go number one, I think that’s the number one issue, they go to the emergency. The other thing they go to the emergency is loneliness, especially within seniors, they’re lonely. And when they have their heart beats, instead of taking deep breath, instead of drinking water and walking, and the food they eat, of course, is terrible. They feel that they’re dying, and so they call 911. So that fear also and loneliness is also causing an any group that Mona and I worked, we could recommend it. That has been something amazing that you can like, not most of them don’t use emergency at all. We taught them how to take deep breaths, we taught them how to call someone else and have a chat. We told them, we teach them how to eat healthy food, and go to the bathroom. And they all say I don’t use emergency anymore. I didn’t know it was harming this machine is what happened to me. And so, we are reducing the usage of emergency within the cohorts we’re working with, which is amazing.

Kurt 

And I think, you know, kind of going back to the broader theme, it’s all about trust, right? If people don’t trust the interpreter, if they don’t trust the primary care doctor that they see for six minutes, they’re not going to open up and share those stories in the way that they share with your group. And I think that some of those stories that you told they were amazing, and how those stories of health and trauma that lead to health issues were never communicated to the physician.

Mariam 

Yeah, and I have them if you want me to repeat, I actually I have a list of them. And they told us they’ve never shared. And you know, some of them, we have to really beg them to tell. And they were all crying. And we were all crying with them when they were sharing these stories, because it was the first time they’ve shared it a group, forget about a doctor.

Mona 

And this part of being able to share this happens probably in the fourth or fifth week. So yes, those weeks before the time are of building friendship, so that these stories can then come out. And you know, their ability to share the story, their ability to talk about their health and articulate is another very important part of what our program is addressing. How do we articulate how do we give health explanations that will make sense when I talk to my doctor, so they get a chance to do that here?

Mariam 

So, this woman, her name is MH, we just we don’t like to use the names. And these are her words, in Somali and we kind of brought it down in English in a broken English it comes out. I didn’t want to change the words. So, it says I was in Mogadishu with my family in a neighborhood called Baqarah. And one day there was an explosion that rocked the neighborhood. Probably it was a war between two factions, we have to run away without looking back. We did not take anything with us. Unfortunately, I lost two of my kids, a boy, and a girl. When we were running for our lives, I’ve can’t find them. And I don’t know where they are. Even today. I am so sick all the time. And the doctors give me medications. But the main issue for me is the fact I’m a mourning mother, who’s missing her kids for the last 16 years. I wish I will know if they’re dead or alive. Because one of my kids got severely sick, of the kids that survived, so the UN sponsored me to come to the United States. My daughter who is here loses consciousness several times a week. We think it was the trauma she experienced while we were running away. This program has been helpful to me because I talk about my issues. And I get relief by talking about it. That’s what she told us.

Mona 

And this is the person who was also on heart medication.

Mariam 

Yes, she was on heart medication, and she didn’t know why. And once we help her with her doctor, she’s no longer taking any medications.

Kurt 

So, there were no issues really with her heart. It was mental trauma. And her primary care physician had never heard any of this. So, he was continuing to prescribe heart medication.

Mariam 

Yes. And she said I was just a mourning mother; I was mourning for my children. So, my heart was broken. So, this is another woman, it’s interesting. Her name was A. I was at Ballad Howa, a border town between Somalia and Kenya. She said I had two children. And I had my husband with me. One day we heard thunder noise, which sounded like rain. But we realize it was not rain but gunfire. I witnessed people near me as they were hit by gunfire. People were dying in the front and to the side. I fell on the ground and lost consciousness. They took me to the hospital near Mandara. While I was in the hospital, the gunfire continuing and reaching where I was my neighbor was killed. We went to a camp and it was not safe there either. I witnessed the killing of a little girl and fainted again. I finally came to a Kenya camp but had a hard time sleeping all my life. I saw a doctor here and he said I have some pain in my heart as it beats above normal. During my life here, even though it’s relatively peaceful, I always see all the things that I have seen. My doctor advised me to talk about it, as I’m doing now. I’m getting better by eating right with your program and seeing all of you makes me happy. Also listening to other people who went through worse things than mine helps me. Can you believe it?

Kurt 

Very powerful. And the ability to connect a program ostensibly around food and health to this sort of mental and behavioral health, sharing, to open up and to be able to share those stories is something that just doesn’t happen in a traditional hospital or clinic setting.

Mariam 

Yeah, and many, I can tell you over 80% or 90% of the Somalis who come here lost some people. So, they are all traumatized. And what do we do, they come here, and they have to go to the county, they have to find a job, we act, we really treat them as normal people. They have to they have to keep all that and then what do they do? They’re all in pain and they go to the doctor. And nobody really connects the dots of saying we these people need healing you know; they need someone to listen to them. You know, I lost my sister and my brother-in-law in the war and I was here, and I was devastated, I was in America but my sisters — one thing I realized, when Somali people talk about death, they don’t feel sad, you know, when they told me this story, people I knew died. I feel, oh my god, and they’re all laughing, and I say what’s wrong with you, why you’re laughing? And they said we get used to it. We see so many people die. It means nothing to us. So, you know it’s like the soldiers who go to war, when they come back. You know, it’s a trauma, all the communities in trauma, you know and people, I don’t think we talk about it. I think The Center for Victims of Torture is an organization that has been helpful to the Somali community at the beginning. But lack of funding, the community does not get a space of relief where they can talk about their work and their wounds. And then how do they raise the mothers? How will they raise their children, they can’t. All they know is they’re robots. They’re robots, they wake up, they do this thing. It’s not about them. And then they collapse. And when they collapse, they go to the emergency.

Mona 

It’s interesting that even with each other, they don’t share these stories. So, in some cases, and many of the cases, of the stories you shared, were the first time that they shared their story like that in public with their friends, because they are all living in their own isolated worlds, which is doing their work, like you say, just getting up and doing it, you know, taking care of their children, their husbands, and not thinking about themselves. So, we’re creating a space for the first time to say, take a deep breath, literally, you know, when we work with breath, let’s say some prayers, and we’re meditating on these themes. Maybe it’s on faith or gratitude or resilience. And take time. And that’s one thing that they don’t often have. And so, we’re almost forcing that issue by creating a bubble that allows them to reflect, to breathe, and to take some moments for themselves, which you would think is what’s that? You know, is that so important, but it’s extremely important in this context, for healing.

Kurt 

Yeah, that’s just an amazing approach to take a culturally sensitive way, combining different needs, but ultimately recognizing that there’s this shared trauma, this post-traumatic stress, right, trauma that permeates the community. And that is an important barrier to consider in the healthcare system, and our healthcare system, quite honestly, just isn’t set up to manage that.

Mona 

And that’s, that’s okay. But how do we rectify? And how do we fill that gap? If that’s the case, and they’re doing their jobs beautifully? How can we do our jobs just as well, and help connect these two entities so that these community members aren’t being left isolated and alone, suffering with their trauma, but addressing the trauma and helping them interface better with that community, so that we can both do our jobs and these women, and these individuals are getting attended to

Kurt 

It’s very important work, I appreciate your sharing these stories. And I hope that our listeners who are dealing with different cultural communities have their own for patients and members are able to reach out to you and, you know, continue the conversation.

Mona 

And this is designed, you know, we’re working within the Somali community. But as I said, the components are adaptable. You know, when we talk about the Quran, and the Somali community, or other communities, that we would, you know, address and use different meditations.

Mariam 

This can be used in any community. You know, we have a lot of mainstream friends who love this program. Now, this is just UCare funds only the Somali community now, because that’s where, you know, they have largest number of members, that I think Somalis mostly are UCare members. And so that’s why they’re funding but I think it we want to use it, and hopefully in the future, in any, it’s applicable in any community.

Kurt 

Wonderful. Thank you for sharing more about Intercultural Alliance and I look forward to catching up with you in the future.

Mariam 

Thank you so much.