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 25,000Lowell 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 AsiaServices: 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 Period1979: Vietnamese invasion Refugees flee to Thai border1979-86 Resettlement in U.S.

Partnership Examples  Nutrition Learning

Health Education

Health Screenings

Elements of LCHC – Buddhist Temple Partnership 1. Metta

Health screenings (diabetes)Flu shotsNew Years Outreach (New Years is in April)Meet together regularly Monk is official consultant, name tag, welcome to mental health teamMonk gave the name for Metta Health Center = loving kindness, one of the four basic approaches of Buddhism Monk participated in planning the CenterMental health – taking people to the temple, recommending ceremonies, depending on patient’s particular problem

Public Health & Faith Institute, Emory UniversityMonks 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 monkMeditation Center

2. CCH 2010

Health Fairs/Booth at New YearsMeditationHealth education sessions at the temple on diabetes, CVD, nutrition, including special night in lunar calendarElders’ Council Remembrance Day for 9/11, Khmer Rouge victims with monks chanting and diabetes, blood pressure screeningCommunity behavioral risk factor surveyLearning tours with monks in attendanceBo 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 homes99% born in Cambodia87% Buddhist, 10% over 50 meditate28% get health information from temple/church96% always speak Khmer at home73% used traditional treatments

3.  Cambodian Health Service Improvement Program/Reaksmey Sangkhim

Patients go to temple for detox and recoveryPatients go to temple for teaching and then help clean up or cook to give community serviceMonk at AIDS Walk, spokeField trip to Kirivongsabopharam TempleMeditation/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 EducationTemple became smoke freeCambodian weddings no longer give cigarettes as part of reception practicePSA 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 alcoholCutting desire leads to less suffering and less anxietyImpermanance of life, get old, get sick,

die – can’t avoid itBasic 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 illnessTreatments

Restoring balance • Coining (rubbing the wind), Cupping (sucking the

wind), Pinching (pinching the wind)• Hot-cold balance

Addressing spirits

Western medicineInjections / Medications

Traditional HealingKoh 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

Spiritual HealingReligious 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 buddhistMost 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 problemsDesire causes problems, suffering

Building the RelationshipDifferent for Khmer and Non-KhmerMust be flexible enough to fit in with monks’ time and availabilityLong term relationship buildingPassed 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 practicePay 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 auditOwn sense of timeMust eat before noonTransportation – usually don’t drive, not supposed to according to religionDifferent language used with monks and a lot of younger generation staff don’t know how to speak that wayDon’t speak much English and difficult for lay person to translateOften 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 & ChallengesBecause only small number of monks, greatly in demand and have limited time to spend with usSome monks are responsible to other towns/temples, sometimes far away, e.g., South CarolinaDifferent 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 monksDifferent 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 soberHelped mental health

patients relax and get rid of sufferingEmpowered elders to lead others

Useful Resources

Interfaith Health Program of Emory University: www.ihp@emory.eduMN Web Site: www.GreatWisdomCenter.orgwww.dhamma.org

Lowell Community Health Center Contact Information

Sonith Peou, Director of Metta Health Center: sonithpe@lchealth.orgSidney Liang, Director of Cambodian Community Health 2010: sidneyli@lchealth.orgBunrith Sath, Coordinator, Reaksmey Sangkhim: bunrithsa@lchealth.orgDorcas Grigg-Saito, Executive Director, LCHC: dorcasgr@lchealth.org

Thank You

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