Transcript Lowell Community Health Center

Faith and Health Partnerships
Lowell Community Health Center
Trairatanaram Temple, Glory Temple,
Kirivongsabopharam Temple,
Watmixyaram (Lao) Temple
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
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
The Cambodian Experience
 1970-75: War, social
disruptions; movement from
countryside to cities
 1975-79: Pol Pot Period
 1979: Vietnamese invasion
Refugees flee to Thai border
 1979-86 Resettlement in U.S.
Partnership Examples
Nutrition Learning
Health Education
Health Screenings
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
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
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
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
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
4.
Men of Color Program
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
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
Mental Health
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.
Health Beliefs
– 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
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
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 gastrointestinal 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
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.
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
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
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.
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
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.”
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
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
Useful Resources
Interfaith Health Program of
Emory University:
[email protected]
MN Web Site:
www.GreatWisdomCenter.org
www.dhamma.org
Lowell Community Health Center
Contact Information
Sonith Peou, Director of Metta Health Center:
[email protected]
Sidney Liang, Director of Cambodian
Community Health 2010:
[email protected]
Bunrith Sath, Coordinator, Reaksmey
Sangkhim: [email protected]
Dorcas Grigg-Saito, Executive Director, LCHC:
[email protected]
Thank You
Sidney Liang, Project Director of Cambodian Community
Health 2010, created many of the slides used in this
presentation.