Faith and Health Partnerships

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Faith and Health Partnerships

• Lowell Community Health Center
• Trairatanaram Temple, Glory Temple,
• Kirivongsabopharam Temple,
• Watmixyaram (Lao) Temple

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                   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

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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

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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.

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Partnership Examples  
Nutrition Learning Health Education
Health Screenings
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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 patients
  particular problem

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• 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 Years celebrations at the health center with
  blessings from monk
• Meditation Center

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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
  childrens attention to their parents health

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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

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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

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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

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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 Dont lie, kill, steal, commit
  adultery, drink alcohol
• Cutting desire leads to less suffering and less
  anxiety
• Impermanance of life, get old, get sick,
• die cant avoid it
• Basic qualities should seek loving kindness,
• compassion, equanimity, sympathetic joy

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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.

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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

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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

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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 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

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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.

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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

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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

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  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.

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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 cant take money, no way to get social
  security number for audit
• Own sense of time
• Must eat before noon
• Transportation usually dont drive, not
  supposed to according to religion
• Different language used with monks and a lot of
  younger generation staff dont know how to speak
  that way
• Dont speak much English and difficult for lay
  person to translate
• Often dont get out of the temple much

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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.

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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

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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

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Useful Resources

• Interfaith Health Program of Emory University
  www.ihp_at_emory.edu
• MN Web Site www.GreatWisdomCenter.org
• www.dhamma.org

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Lowell Community Health Center Contact
Information

• Sonith Peou, Director of Metta Health Center
  sonithpe_at_lchealth.org
• Sidney Liang, Director of Cambodian Community
  Health 2010 sidneyli_at_lchealth.org
• Bunrith Sath, Coordinator, Reaksmey Sangkhim
  bunrithsa_at_lchealth.org
• Dorcas Grigg-Saito, Executive Director, LCHC
  dorcasgr_at_lchealth.org

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