You Should Be Healthy - The Jewish Community Federation of Cleveland Advances Women's Health in Israel
“Did you remember to worry about yourself?” reads a poster advertising physical exercise classes for women at a local community center; ‘Join us in learning how to integrate physical activity into your busy life.” Exercise and physical health classes such as these have now been carried out in 40 community centers all over Israel so far, as part of Project ISHA (Israel Health Advancement for Women), an initiative of the Jewish Community Federation of Cleveland. ISHA is a comprehensive project in women’s health that is slowly bringing about structural change in medical treatment for women, and raising awareness on women’s health issues in Israel.
“We have just established women’s’ programs in seven community centers in the North,” says Hanna Soltz-Aharony, director of Project ISHA, “and that’s just in the Galil. We aim our programs at women from all sectors of Israeli society: Secular Jewish, Druze, Ethiopian, Bedouin, ultra-Orthodox, everyone.”
Why would a medically advanced country like Israel need such a project? The results of a 2002 study on women’s’ health by JDC’s Brookdale Institute revealed surprising results, prompting the Cleveland Federation and the Jewish Agency for Israel to launch ISHA in 2002.
The study found that Israeli men ranked third among Western countries in terms of life expectancy, while women came in far down the list at number 12.
There is a multitude of factors that may have influenced these results, but a lack of general awareness on women’s’ health among the medical profession, and even among women themselves, may be a part of the problem, an issue which ISHA has been slowly changing.
“A woman’s body works differently from a man’s body,” says Soltz-Aharony, “but not everybody is aware of this.”
Take heart disease, the leading cause of death among Israeli women aged 55 +, which in many instances, goes undiagnosed. “If a woman comes to a doctor complaining about shortness of breath, or a back-ache, or aching gums, in most cases, he will tell her to rest, or that she’s got a cold, or even hysteria. If a man comes in complaining about shortness of breath or aches, they will immediately attach him to an ECG machine,” Soltz-Aharony points out. “There are many stories of women being sent home undiagnosed by doctors, only to suffer a heart attack at home, or they only get it discovered once they insist on getting an ECG.”
Moreover, the symptoms for heart disease can be significantly different between men and women. For many women, back-pains and sore gums can also be symptoms for heart disease, but many doctors are not aware of this.
While stories such as these are still common, much has changed since the launching of ISHA. ISHA has been working with the Clalit Health Fund (the largest government provider of health services in the country) to establish Continuing Medical Education, or CME, for doctors working in 250 Clalit clinics in Israel. This has helped boost the availability of women’s health services in peripheral towns. Doctors in Clalit clinics learn about different aspects of women’s health from early adulthood to old-age in an 18-lesson course. “15,000 doctors have undergone training so far, and they are improving their ability to communicate with women on medical matters,” says Soltz-Aharony proudly. ISHA is currently implementing this program in other Israeli health service providers, such as the Maccabi Health Fund. In addition, ISHA was instrumental in establishing Women’s Health as a unit of learning in Israeli medical schools.
ISHA has also launched a program in the Israel Defense Forces for female soldiers with a low score on their mental and physical health profiles. These women learn about personal health and issues such as safe sex in a series of workshops. 94% of female soldiers in this category have undergone training so far.
An essential part of raising awareness about women’s health has been ISHA’s work with Israeli women themselves. ISHA runs a training program for nurses in new born baby clinics known as Tipat Chalav, where they learn about health, exercise and nutrition. “Many nurses did not know how to read food labels,” says Soltz-Aharony, “for instance, what are poly- and mono-unsaturated fats? What is cholesterol? The nurses had a complete mind-set switch when we started focusing on what they themselves eat, not just what babies eat. We gave them all step counters, and there was greater awareness about the need to move and to exercise.” Soltz-Aharony also mentions that nurses are currently running a course for 27 people in a predominantly Ultra-Orthodox area in Bet Shemesh, on the importance of physical activity, as well as training currently underway for 20 nurses at an east Jerusalem clinic.
The fact that nurses are training the women they treat to take care of themselves as well, creates a powerful ripple effect.
Another important project has been initiating women’s leadership in advancing health within their own communities. ISHA works with groups of 15-20 women in their 40’s and 50’s with leadership potential, who are retired nurses, teachers and social workers. The groups undergo a 60 hour course on women’s health, leadership, and marketing. Toward the end of the course, they learn about project implementation and project management. The women are taught how to map a community’s needs and demands, after which they undertake a small project of their own. “In Ramle, the group undertook a number of workshops on healthy cooking, exercise, and nutrition,” says Soltz-Aharony. “There were 250 women, including Israeli-Arabs, Ethiopian-Israelis, and Jewish secular women.” The project, which was implemented at the local community center, continued for two more years, after which a walking club for Arab-Israeli women was established. A bus takes a group of Arab-Israeli women out from their villages every week so that they can go walking together; an opportunity not afforded them in their communities where it is considered immodest for a woman to go out walking on her own.
Project ISHA is overseen by the Federation-established Women's Health Committee in Cleveland, a group comprised of leading physicians, nurses, social workers, allied health care professionals and advocates in the field of women's health. The committee members and many others in the Cleveland Jewish community play active roles in the project, traveling to Israel and running workshops, or hosting visiting Israeli health professionals in Cleveland, resulting in shared learning.
“The partnership between the Cleveland Federation and the Israeli medical community is the best partnership I have ever seen,” Soltz-Aharony says. “The Jewish Community Federation of Cleveland truly raised awareness of an issue that had never been previously understood. Today you see a change in health services, and even in the Ministry of Health. Did Cleveland achieve all of this on its own? I don’t know. But the fact is, that there’s a change.”
Physical education for nurses in Jerusalem