Anja Kammacher, O'T'

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CARING FOR THE HEROES

• by
• Anja Kammacher, O.T.
• Alexandra Gomes, nurse
• Burcu Akpinar, nurse
• Eva Marie Castro, speech
• Fredrik Arneberg, nurse
• Mette Jensen, midwife

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Disposition

• The arguments of this project
• The facts of Somalia
• Safias journey
• The Somali environment in Scandinavia
• Safia in Denmark (movie)
• The ICHCI center
• Discussion

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Why did we choose this subject?

• We have all met Somali women in our daily-life
• Its a group we will meet in our future
  healthcare practice
• There is a lot of prejudice about this group in
  our home countries
• Somalis often suffer poverty
• - Mental, material, social
• Somalis are a group of people who are in contact
  with all our countries
• - Turkey, mostly as a transit country
• - Belgium, Norway and Denmark as the countries
  the Somalis wish to live in
• Social economic aspects due to the fact that
  Somalis commit a lot of crime and are often
  unemployed
• We were inspired by the site visit to a place
  called Sundhedshuset

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Somalia
Capital Mogadishu Population Approx.
8.228.000 Average age of mortality 47
years Government No effective national
government since 1991 GDP (BNP) 600 pr. capita
(Norway 42.364) Diaspora There are over
1.000.000 Somalis (including the minorities)
outside Africa. Religion Almost all Somalis are
Muslims
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Facts about Somalia

• General
• 73 live beneath the poverty limit
• 70 do not have drinkable water
• Somali people are likely to suffer from Post
  Traumatic Stress Disorder (PTSD) because of their
  war experiences

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Facts about Somalia

• Children
• 10 of children die at birth
• 25 of those who survive birth,
• die before they are 4 years old
• A one-year-old child weighs
• approximately 3-4 kg
• (a Danish one-year-old weighs 10-12 kg!)

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Facts about Somalia

• Women
• 98 of all Somali women are victims of
  genital mutilation
• which often leads to infections, chronic pain
• and infertility
• 85 of the women are not educated

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Family structure and relationships

• Tend to live together with several couples and
  three generations
• Usually the bride lives with her husband's family
  
• Men are providers and women take care of house
  and children
• Marriage is arranged by the family, but the young
  people themselves make the final decision
• Marriage between cousins are common

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• Different methods
• Boat
• Plane
• Through
• Dubai
• Yemen
• Saudi Arabia
• Turkey

America
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Safias journey

• Lives in Mogadishu and was married two years ago
• A tribe tortured and killed her family
• Everyone thought she was dead and therefore she
  cant return to home and has to escape
• Meets an embezzler and goes on a boat with 50
  other Somalis
• Only eats once every 2nd or 3rd day and is raped
  on the boat
• Arrives after 30 days in Europe (Turkey)

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Safias journey

• In Turkey she meets African people
• Finds a house where 25 people live in the same
  room
• In a week she eats 3 times and in a month she
  showers 1 time
• She starts working in a factory but doesnt earn
  enough money
• Again she meets an embezzler
• New journey begins through Europe to Denmark
• Finds her husband and the family is reunited

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Family-reunion in Denmark

• Husband/wife, co-habiting partner or registered
  partner
• Children under the age of 18 years old

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Family-reunion in Denmark

• Both have to be at least 24 years old
• Has to live in the same address
• United relation to Denmark should be bigger than
  their united relation to any other country

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Family-reunion in Denmark

• THE PERSON IN DK
• Have to be a Danish citizen or a refugee
• Reasonable place to live
• Size-wise and rental-wise
• Should be able to support the arriving person
• Make sure to have at least 6800 euros to cover
  possible public expenses

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Some figures

• Family-reunion 2004-2005

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FAMILY-REUNIONIN DENMARK
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CONDITIONS IN SCANDINAVIA

• 4 of the ethnic group is from Somalia
• 60 of them arrived during the last 6
  years
• 3 of 4 are unemployed
• 5,1 have been convicted of a crime

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THE SOMALI WOMAN IN SCANDINAVIA

• Her place is at home with the children
• She can not read or write
• Her husbands family is the only family she has

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THE MEDIA

• Descripes the Somali as people that
• Have low income
• Have little or no education
• Are unemployed
• Commit a lot of crime

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Why cant they integrate??

• Factors in Somalia
• War
• Kaos
• Famine
• Poverty
• No Laws

• Factors in Scandinavia
• Laws
• Papers to fill out
• Lack of good network
• Stigmatzation by the media
• Different cultures and religions

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THE EVIL CIRCLE

• No money
• No jobs Crime
• Employers wont hire

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• What happens if the Somali woman leaves her
  husband?

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• MOVIE

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CENTER

• Place for Somali women and children
• Our ideals
• Prevention promotion
• Help to self-help
• Work on the integration-process by being aware of
  not creating a parallel society
• Open
• Monday to Friday 8 am to 5 pm
• Twice a week to 9 pm
• Located in the center of the capital

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CENTER

• Interdisciplinary
• NURSES MIDWIFES SPEECH THERAPIST
• OCCUPATIONAL THERAPIST HOME VISITOR
• SOCIAL WORKERS DOCTOR INTERPRETOR
• PSYCHOLOGIST

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• NURSES
• Check nutrition-status and give advice
• Mental screening
• Hygienic advising
• Wound-care
• Physical examination
• Medicine
• Support and security

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• OCCUPATIONAL THERAPIST
• Activities of Daily Living
• Structure
• Advice and information about possibilities in the
  surrounding society

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• MIDWIFES
• Contraception information
• Genital mutilation consultation
• Pregnancy consultation before, during and after
• Advice about
• diet
• exercise parenthood

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• SPEECH THERAPIST
• Training in communication skills
• Writing a job application
• Giving confidence and find inner strength back
• Helping to understand the Western communication
  verbally and nonverbally
• Pronunciation

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Communication in a multiracial society

• Communication lies at the heart of health care
  delivery. To be effective it must give patients
  the information they want and need and it must
  listen and respond to them. And it must do this,
  as far as possible, in a way that is tailored to
  the individuals unique blend of beliefs,
  understanding, expectations and ability to
  communicate.
• (Schott Henley, 2003)

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The basic principles of good communication

• Good manners
• Courtesy and respect
• Look out for clients needs
• Reduce vulnerability and uncertainty
• Two-way communication

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Communication across cultural barriers

• Make sure your client understands the information
  given
• dont judge me by the way I look or dress. Talk
  to me and try to understand who I am not what I
  am
• (Schott Henley, 2003)

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The client-centered approach

• It is a non-directive approach to therapy,
  directive meaning any therapist behavior that
  deliberately steers the client in some way

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• Listen and try to understand how things are from
  clients point of view
• Check the mutual understanding with the client if
  unsure
• Treat the client with the utmost respect and
  regard

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• There is also a mandate for the therapist to be
  congruent, or transparent which means being
  self-aware, self-accepting, and having no mask
  between oneself and the client. The therapist
  knows themselves and is willing to be known

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• MOVIE

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DiscussionHow much is too much?- economic-
integration- parallel society- ethics
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References

• Aksiyon Dergisi, Aydemir
• Schott, J. Henley, A. Culture, Relgion and
  Childbearing in a Multiracial Society. 2003
• www.sykepleien.no
• www.hurriyetim.com
• www.un-somalia.org
• www.lommelegen.no
• http//world.std.com/mbr2/cct.html
• www.dagbladet.no
• www.aftenposten.no
• www.novib.nl
• www.reisomdewereld.nl
• www.udlst.dk
• www.flygtning.dk
• www.ssb.no