:: Intercultural mediation - concept
We define intercultural mediation as all activities that aim to reduce the negative consequences of language barriers, socio-cultural differences and tensions between ethnic groups in health care settings. The final purpose is creating health care options that are equal for immigrants and native-born patients regarding accessibility and quality (outcome, patient satisfaction, respect for the patient’s rights and so on). Intercultural mediation is in fact a way to achieve this by improving communication and thus acting strategically on the care provider/patient relationship. In this manner especially the patient’s position but also but also the care provider’s position is strengthened so health care is better suited to patient needs and the care provider can work efficiently.
Besides bridging the language and cultural barrier, an important dimension of intercultural mediation is also facilitating the therapeutic relationship between the care provider and the patient (Qureshi,2011). Intercultural mediation will, according to Chiarenza (quoted in Pöcchacker, 2008), also contribute to complete organisations better adapting their services to the needs of immigrants.
The accessibility and quality of care for migrants and ethnic minorities (MEMs) suffers strongly from language barriers, socio-cultural barriers and possible interethnic tensions, racism and discrimination. In order to offer MEMs equal access and quality of healthcare, it is necessary to take actions to minimize these obstacles as the intercultural competences of healthcare institutions are often too limited to address these challenges alone. This can lead to ethnic healthcare inequities.
The Belgian Government has made the choice to deploy intercultural mediators and not interpreters: mediators can not only overcome the language barrier but also deal with other barriers such as unequal quality and access to healthcare.
In 1991, a first intercultural mediation program was launched for a five-year period, financed by various Flemish and Brussels Ministries, and coordinated by the Flemish Centre for Integration of Migrants (Vlaams Centrum voor de Integratie Migranten) and – in 1992 – by Foyer.
In 1999, thanks to the success of these projects, a specific program and related funding were established at the FPS Health, which progressively grew in importance. Nowadays, more than 50 hospitals benefit from this program. There are around 20 languages covered and 100 intercultural mediators working all over the country.
In this framework, there are various languages which can be of benefit to Roma migrants.
Besides carrying out on-site interventions, the intercultural mediators are also providing video-remote intercultural mediation services in hospitals, primary care centers and medical services working with refugees. This solution allows for a wider coverage all over the country, even if a direct, on-site intervention seems to be a preferred option.
Every year in December, FPS Health invites general and psychiatric hospitals to apply for funding for intercultural mediation (to cover the posts of intercultural mediator and/or diversity manager). The application form must be sent to the FPS by the 31 January of each year. The Intercultural Mediation & Policy Support Unit then reviews the applications and is responsible for the assessment and management of the intercultural mediation initiatives.
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