African and in USA; Locating Acculturation needs and Culturally Competent Care Spaces for Migrant Populations From Africa; a Public Health Perspective

Introduction:

The BayHeal Manager, took some time off observing how Africans who are new in America fit into the American urbanite-First World Society. Four geographic locations were the focus (served as exit brief cursory interview points too) of this field rapid analysis between March-May 2016 on different days of the week: Berkeley Town Farmer's Market; Embarcadero Market; San Francisco Civic Centre Farmer's Market; and Hunters Point (Kirkwood and Our Lady of Lourdes' Community Days for Seniors). The manager talked to 28 persons and this is their brief characteristics and typology: 

(a). Males above 35 years (5); males below 35 years (3); female above 35 years (4); female below 35 years (5); female above 65 (4); males above 65 (5); female below 22 years (1); and male below 22 years (1). 

(b). They have lived in USA between 10-37 years

(c). 5 were born in USA; 10 are naturalized Americans; 10 are permanent residents; 3 are in process of formalizing their stay documentation.

(d). 10 last attended a medical clinic when they were formalizing their green card eligibility.

(e). 5 have senior-related ailments that require regular medical check ups but 3 have missed two recent appointments.

(f). For 15, fresh foods, green vegetables and foods low in carbohydrates and protein are a concern (8 drive; all have expert street knowledge of locales in Bay Area or Northern California and mobility skills; 3 reside in Palo Alto; 2 live in San Francisco City; 2 live in Richmond; 1 lives in San Leandro;2 live in Berkeley; 3 live in Alameda; and 2 live in Antioch.

(g). For 10, have needs for understanding and managing a balanced diet and incorporating it as a life skill.

(h). 8 smoke and consider themselves chainsmokers.

(i). 15 expressed need for information on hazardous conditions, avoiding exposure and vulnerability (physical, sexual and social).

Public Health Significance:

Public health interventions, are possible and can be optimized  for African immigrants when African community-owned leaders are involved. In conducting this cursory interview, the BayHeal manager/health educator managed to generate interest in health issues. It is possible to tailor health campaigns targeting African immigrants. Such messages can be motivating when they show show how quality of life of African can be improved; when the programs are geared at improving health, physical activity, nutrition conscientization, disability reduction and decrease risks or vulnerability.

African immigrants need literature and awareness drives on exposure to hazardous conditions at work; exposure to hazardous conditions at homes; and understanding how to avoid transmission of infections. Community awareness sessions that raise conscience on practices that are particularly risky such as unprotected sex with multiple partners, commercial sex trade, IDU, early unprotected sexual intercourse and vulnerability within sexual networks (protecting partners of persons at risk).

Language and knowledge of say, addresses may influence access and usage of health promoting technologies/tools of healthcare or self-care. When key-leaders among African communities are identified and trained in peer-to-peer skills, they will be able to conduct community diagnosis of needs and report them for interventions.

Methods:

There is need to appreciate where most African immigrants live/reside and map out resources that are accessible to them. This will improve on their ability to demand and share the community resources in their different locales or addresses. It will also be possible to have interventions that address high risk behaviors and show how Africans can benefit from the social or physical environment in their area. This increased awareness risks and of community intervention resources is significant in health promotion and disease prevention.

Organizing for health promotion will require community partnerships and involvement; visioning to pursue common goals; assessment of forces of change, themes, systems; understanding prevailing community health standards and required status; identifying strategic issues; and formulating common goals.

Data on African immigrants that can be used to formulate quality health goals need not to be complicated. Collecting material that reflects character and typology is all that suffices. As much as possible point out health disparities, build an epidemiological profile and plan for or implement appropriate cultural/linguistic interventions. A community profile can capture: kind of population; language used; age; employment opportunities; incomes; skill levels; education; household status and compositions; ethnicity; information such as: insurance coverage; health/medical needs; and community events' involvement.

Work with community-owned resource persons within the African communities. This will make available experts in community's language, cultural beliefs, demographic intelligence that assists in offering culturally competent care environment. In such as an environment or space, it is possible for health care providers to educate community on specific diseases, risk factors and health promoting practices.

For persons involved in community mobilization and organization, knowledge of computer operation and directional finding using say, GPS locator tools is also a big help. There are different apps and tools available on phones or different interface platforms.  A GPS coordinate converter or other tools that the author relies on include: http://www.gps-coordinates.net/gps-coordinates-converter; Google maps; http://driving.directions.cm/lp/?partner=^BXV^xdm003&s1=google_ddcmdirections.

Conclusion:

It is no doubt that there is need to train African community leaders in: relational skills; collaboration skills; accountability; strategic planning; movement building; organized planning; involving as many people as possible; use of objectives to assess short or long term program outcomes; assist communities to improve health and quality of life; and developing information exchange platforms that increase participation in health care demand and delivery.